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. 2022 Mar 15:2022:5879187.
doi: 10.1155/2022/5879187. eCollection 2022.

The Impact of Intracoronary Imaging on PCI Outcomes in Cases Utilising Rotational Atherectomy: An Analysis of 8,417 Rotational Atherectomy Cases from the British Cardiovascular Intervention Society Database

Majd B Protty  1   2 , Sean Gallagher  1 , Andrew S P Sharp  1   3 , Vasim Farooq  1 , Mohaned Egred  4 , Peter O'Kane  5 , Peter Ludman  6 , Mamas A Mamas  7 , Tim Kinnaird  1   7
Affiliations

The Impact of Intracoronary Imaging on PCI Outcomes in Cases Utilising Rotational Atherectomy: An Analysis of 8,417 Rotational Atherectomy Cases from the British Cardiovascular Intervention Society Database

Majd B Protty et al. J Interv Cardiol. .

Abstract

Introduction: There is increasing evidence supporting the use of intracoronary imaging to optimize the outcomes of percutaneous coronary intervention (PCI). However, there are no studies examining the impact of imaging on PCI outcomes in cases utilising rotational atherectomy (RA-PCI). Our study examines the determinants and outcomes of using intracoronary imaging in RA-PCI cases including 12-month mortality.

Methods: Using the British Cardiac Intervention Society database, data were analysed on all RA-PCI procedures in the UK between 2007 and 2014. Descriptive statistics and multivariate logistic regressions were used to examine baseline, procedural, and outcome associations with intravascular imaging.

Results: Intracoronary imaging was used in 1,279 out of 8,417 RA-PCI cases (15.2%). Baseline covariates associated with significantly more imaging use were number of stents used, smoking history, previous CABG, pressure wire use, proximal LAD disease, laser use, glycoprotein inhibitor use, cutting balloons, number of restenosis attempted, off-site surgery, and unprotected left main stem (uLMS) PCI. Adjusted rates of in-hospital major adverse cardiac/cerebrovascular events (IH-MACCE), its individual components (death, peri-procedural MI, stroke, and major bleed), or 12-month mortality were not significantly altered by the use of imaging in RA-PCI. However, subgroup analysis demonstrated a signal towards reduction in 12-month mortality in uLMS RA-PCI cases utilising intracoronary imaging (OR 0.67, 95% CI 0.44-1.03).

Conclusions: Intracoronary imaging use during RA-PCI is associated with higher risk of baseline and procedural characteristics. There were no differences observed in IH-MACCE or 12-month mortality with intracoronary imaging in RA-PCI.

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Conflict of interest statement

MM reports holding unrestricted educational grants from Boston Scientific, Terumo, and Abbott. All other authors report no conflicts of interest relevant to this work.

Figures

Figure 1
Figure 1
Trends in intravascular imaging use in RA-PCI performed in England and Wales, 2007–2014. (a) Crude numbers of imaging (dark grey bars) and nonimaging RA-PCI cases (light grey bars); (b) percentage of RA-PCI cases utilising imaging as a proportion of all RA-PCI demonstrates an initial rise followed by a plateau (p for trend <0.001).
Figure 2
Figure 2
Multivariate logistic regression for intracoronary imaging use by baseline comorbidity in patients undergoing RA-PCI in England and Wales, 2007−2014. CI: confidence interval.
Figure 3
Figure 3
Adjusted outcomes by intracoronary imaging use in patients undergoing RA-PCI in England and Wales, 2007−2014. CI: confidence interval; MACCE: major adverse cardiac and cerebrovascular events.
Figure 4
Figure 4
Subgroup analysis of adjusted 12-month mortality by intracoronary imaging use in RA-PCI in England and Wales, 2007−2014. CI: confidence interval; MACCE: major adverse cardiac and cerebrovascular events.
See this image and copyright information in PMC

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