Outcomes of rotational atherectomy followed by cutting balloon versus plain balloon before drug-eluting stent implantation for calcified coronary lesions: A meta-analysis.
Catheter Cardiovasc Interv
; 99(6): 1741-1749, 2022 05.
Article
em En
| MEDLINE
| ID: mdl-35366389
ABSTRACT
OBJECTIVE:
The aim of this study is to compare outcomes of rotational atherectomy and cutting balloon (RACB) versus rotational atherectomy and plain balloon (RAPB) before drug-eluting stent (DES) implantation in calcified coronary lesions.METHODS:
Randomized controlled trials (RCT) and observational studies comparing RACB with RAPB were identified through a systematic search of published literature across multiple databases. Random effect meta-analysis was performed to compare the outcome between the two groups.RESULTS:
Four studies were included in the meta-analysis (three observational and one RCT) involving a total of 315 patients. 166 patients had RACB, and 149 patients had RAPB before DES placement with a median follow-up of 11.5 months. Compared with patients who had RAPB there was no difference in MACE (composite of death, myocardial infarction, and target vessel revascularization) (odds ratio [OR] 0.74; 95% confidence interval [CI] 0.25-2.18], slow flow/no reflow (OR 0.71; 95% CI 0.23-2.16), all-cause mortality (OR 2.02; 95% CI 0.28-14.60), and device success rate (OR 1.79; 95% CI 0.28-11.18) in the RACB approach. There was a benefit towards less target lesion revascularization in the RACB group; however, this outcome was reported in two studies (OR 0.29; 95% CI 0.08-0.99). On meta-regression there was no association between age, sex, diabetes, or lesion location with MACE and all-cause mortality. The studies were homogenous across all outcomes.CONCLUSION:
RACB, as compared with RAPB, had a similar risk of MACE, all-cause mortality, device success, and complication, but a lower risk of target lesion revascularization.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
6_ODS3_enfermedades_notrasmisibles
Base de dados:
MEDLINE
Assunto principal:
Doença da Artéria Coronariana
/
Angioplastia Coronária com Balão
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Aterectomia Coronária
/
Stents Farmacológicos
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Observational_studies
/
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
Catheter Cardiovasc Interv
Ano de publicação:
2022
Tipo de documento:
Article