Efficiency of rotational atherectomy with drug eluting stents by intravascular ultrasound for elderly patients with heavily calcified lesions / 中国医师进修杂志

ABSTRACT

Objective To evaluate the efficiency of rotational atherectomy (RA) with drug-eluting stents (DES) by intravascular ultrasound (IVUS) for elderly patients with heavily calcified lesions. Methods Thirteen patients aged above 70 years with heavily calcified coronary artery having underwent the treatment of RA and DES by IVUS were enrolled. The levels of troponin T, creatine kinase isozyme-MB and creatinine were detected before and after operation.The levels of minimus lumen diameter, diameter stenosis rate, effective area of the lumen before and after operation were compared. The immediate success rate was evaluated and the follow-up results were recorded. Results Thirteen patients in accordance with angiography and IVUS examination were confirmed as severe calcification. The levels of troponin T, creatine kinase isozyme-MB and creatinine detected before and after operation had no significantly differences (P>0.05). The levels of minimus lumen diameter, diameter stenosis rate and effective area of the lumen before and after operation had significant differences(2.06 ± 0.38) mm vs. (3.98 ± 0.76) mm, (73.26 ± 7.02)%vs. (17.00 ± 3.34)%, (4.53 ± 1.50) mm2 vs. (12.54 ± 6.19) mm2, P<0.01. The rate of left anterior descending artery, circumflex artery and right coronary artery calcification was 10/13, 0 and 1/13. All patients′operation was successful. Followed up for (14.6 ± 3.4) months, no patients had angina and myocardial infarction, or required target vessel revascularization. Conclusions RA with DES by IVUS can be safely used in elderly patients with severely calcified coronary artery disease, and can improve the success rate of intervention operation.