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. 2022 Apr 21;22(1):187.
doi: 10.1186/s12872-022-02622-9.

3-Year outcomes in patients with heavily calcified lesions undergoing percutaneous coronary intervention using cutting balloons

Wei Liu #  1   2 , Yutong Yao #  1   2 , Zhi Jiang  3   4 , Longhai Tian  1   2 , Bo Song  1   2 , Hui Liu  1   2 , Shiyan Deng  1   2 , Rui Luo  1   2 , Fang Wei  1   2
Affiliations

3-Year outcomes in patients with heavily calcified lesions undergoing percutaneous coronary intervention using cutting balloons

Wei Liu et al. BMC Cardiovasc Disord. .

Abstract

Background: Percutaneous coronary intervention (PCI) of heavily calcified lesions (HCLs) is associated with higher complication rates and worse clinical outcomes. Cutting balloon (CB) has been widely used for HCLs, but patients' prognosis had not been fully clarified. The study aimed to compare 3-year clinical outcomes between patients with HCLs that are treated with CBs and those with non-HCLs.

Method: Patients who underwent PCI in Guizhou Provincial People's Hospital from June 2015 to September 2018 were retrospectively included. HCL was defined as radiopaque and high-pressure undilatable lesions. CBs were routinely used in combination with non-compliant balloons for the HCLs. Major adverse cardiac event (MACE) and target vessel failure (TVF) were assessed at 3-year follow-up.

Result: Among 2432 patients included in the study, 210(8.6%) had HCLs with a procedural success rate of 91.0%. The patients with HCLs had a higher incidence of MACE (23.3% vs. 10.8%, P < 0.001) than those with non-HCLs. By propensity score matching, 172 patients with HCLs were 1:1 paired to those with non-HCLs, and their PCI vessels were exactly matched. The MACE and TVF were significantly higher in the patients with HCLs than those with non-HCLs (MACE: 21.5% vs. 13.4%, P = 0.036; TVF: 19.8% vs. 9.9%, P = 0.008). In the Cox regression analysis, HCL is independently associated with higher risks of MACE [HR: 1.72(1.01-2.94), P = 0.047], TVF [HR: 2.10(1.15-3.81), P = 0.015] and repeat revascularization [HR: 2.20(1.07-4.52), P = 0.032].

Conclusion: Patients with HCLs undergoing PCI using CBs in combination with non-compliant balloons had higher risks of complications, procedural failure, and worse clinical outcomes at 3 years than those with non-HCLs.

Keywords: Calcified lesion; Coronary artery disease; Modified balloon; Percutaneous coronary intervention.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Patient flowchart. Abbreviations: COPD = chronic obstructive pulmonary disease; EF, ejection fraction, HCL, heavily calcified lesion; PCI, percutaneous coronary intervention
Fig. 2
Fig. 2
Effectiveness of CB in treating HCLs. Abbreviations: CB, cutting balloon; HCL, heavily calcified lesion
Fig. 3
Fig. 3
Kaplan–Meier survival analysis of 3-year TVF and MACE in the PSM cohort. Abbreviations: HCL, heavily calcified lesion; MACE, major adverse cardiac event; PSM, propensity score matching; TVF, target vessel failure
See this image and copyright information in PMC

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References

    1. Shah M, Najam O, Bhindi R, De Silva K. Calcium modification techniques in complex percutaneous coronary intervention. Circ Cardiovasc Interv. 2021;14:e009870. doi: 10.1161/CIRCINTERVENTIONS.120.009870. - DOI - PubMed
    1. Beohar N, Kaltenbach LA, Wojdyla D, Pineda AM, Rao SV, Stone GW, et al. Trends in usage and clinical outcomes of coronary atherectomy: a report from the national cardiovascular data registry CathPCI Registry. Circ Cardiovasc Interv. 2020;13:e008239. doi: 10.1161/CIRCINTERVENTIONS.119.008239. - DOI - PubMed
    1. Matsukawa R, Kozai T, Tokutome M, Nakashima R, Nishimura R, Matsumoto S, et al. Plaque modification using a cutting balloon is more effective for stenting of heavily calcified lesion than other scoring balloons. Cardiovasc Interv Ther. 2019;34:325–334. doi: 10.1007/s12928-019-00578-w. - DOI - PubMed
    1. Abdel-Wahab M, Toelg R, Byrne RA, Geist V, El-Mawardy M, Allali A, et al. High-speed rotational atherectomy versus modified balloons prior to drug-eluting stent implantation in severely calcified coronary lesions. Circ Cardiovasc Interv. 2018;11:e007415. doi: 10.1161/CIRCINTERVENTIONS.118.007415. - DOI - PubMed
    1. Giustino G, Mastoris I, Baber U, Sartori S, Stone GW, Leon MB, et al. Correlates and impact of coronary artery calcifications in women undergoing percutaneous coronary intervention with drug-eluting stents. JACC Cardiovasc Interv. 2016;9:1890–1901. doi: 10.1016/j.jcin.2016.06.022. - DOI - PubMed

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