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이달의 kcj Hot Article / 2025년 8월
Effect of Operator Experience Performing Rotational Atherectomy on Clinical Outcomes After Percutaneous Coronary Intervention
저자 Woochan Kwon, MD,1 Ki Hong Choi, MD, PhD,2 Young Bin Song, MD, PhD,2 Joo Myung Lee, MD, MPH, PhD,2 Taek Kyu Park, MD, PhD,2 Jeong Hoon Yang, MD, PhD,2 Joo-Yong Hahn, MD, PhD,2 Seung-Hyuk Choi, MD, PhD,2 Jae-Hwan Lee, MD, PhD,3 Min Chul Kim, MD, PhD,4 Hyun-Jong Lee, MD, PhD,5 and Hyeon-Cheol Gwon, MD, PhD2
소속 1 Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
2 Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
3 Division of Cardiology, Department of Internal Medicine, Chungnam National University Sejong Hospital, Chungnam National University School of Medicine, Sejong, Korea.
4 Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.
5 Division of Cardiology, Department of Medicine, Sejong General Hospital, Bucheon, Korea.

Background and Objectives

Rotational atherectomy (RA) is a technique used to ablate calcified plaques. There is speculation that operators’ experience with RA could play a role in the outcomes.

Methods

From December 2015 to April 2020, patients with calcified coronary lesions requiring percutaneous coronary intervention (PCI) with RA were enrolled in a prospective, multicenter, observational registry. The patients were divided into two groups based on the number of RAs performed by their operator in the past. A propensity score matching was done for a sensitivity analysis. The primary outcome was a composite of cardiac death, myocardial infarction, and target vessel revascularization at 1 year.

Results

A total of 497 patients were enrolled in the study. The calculated cutoff number of RA-PCI between the two groups was 82 cases. The more experienced group underwent PCI with less fluoroscopy time (less experienced vs. more experienced, 38.8 vs. 30.0 minutes, p<0.001), and more frequent intravascular imaging (54.6% vs. 69.0%, p=0.012). The primary outcome did not differ significantly between the groups (5.2% vs. 7.3%, hazard ratio, 1.46; 95% confidence interval [CI], 0.57–3.74; p=0.433). No significant difference in the incidence of complications was observed between the groups (5.5% vs. 7.0%, odds ratio, 1.38; 95% CI, 0.57–3.04; p=0.526). Similar results were observed in the propensity-score matched population.

Conclusions

In PCI using RA for calcified lesions, the composite outcome of cardiac death, myocardial infarction, and target vessel revascularization at 1 year was not significantly different according to RA experience among operators.
첨부파일1 KCJ-24-318 GA.jpg KCJ-24-318 GA.jpg (다운 15회)
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