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Incidence, predictors, and consequences of coronary dissection following high-speed rotational atherectomy

D L Brown1, M Buchbinder

  • 1Division of Cardiovascular Medicine, University of California Medical Center, San Diego 92103-8411, USA.

The American Journal of Cardiology
|December 15, 1996
PubMed

Insights

Rotational atherectomy can cause dissection in 12.8% of cases, particularly with tortuous or non-type B lesions. Dissection significantly reduces procedural success, often requiring coronary bypass surgery.

Area of Science:

  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Rotational atherectomy is a key intervention for complex coronary artery disease.
  • Dissection is a known complication, impacting procedural outcomes.

Purpose of the Study:

  • To determine the incidence of dissection after rotational atherectomy.
  • To identify predictors of dissection.
  • To evaluate the impact of dissection on procedural success.

Main Methods:

  • Retrospective analysis of patients undergoing rotational atherectomy.
  • Multivariate analysis to identify risk factors for dissection.
  • Comparison of procedural success rates between patients with and without dissection.

Main Results:

  • The incidence of dissection was 12.8%.
  • Tortuosity, primary lesions, and non-type B lesions were associated with increased dissection risk.
  • Procedural success was lower in patients with dissection (86% vs. 96%, p=0.0001).
  • Dissection led to higher rates of coronary bypass grafting.

Conclusions:

  • Dissection is a significant complication of rotational atherectomy.
  • Vascular tortuosity and lesion characteristics predict dissection risk.
  • Dissection adversely affects procedural success, necessitating further intervention like coronary bypass.

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