Drug-eluting versus bare metal stents after rotational atherectomy: clinical outcome in a single centre

Purpose Heavily calcified atherosclerotic plaques can be prepared for stenting by rotational atherectomy (RA). Clinical outcomes with drug-eluting stents (DES) versus bare-metal stents (BMS) after RA have not been investigated sufficiently. We present a single-centre study comparing the efficacy and, long-term outcome of DES versus BMS after RA. Methods and results We performed a retrospective Cohort study of all patients who were treated with RA at our institution between January 2004 and March 2012. Clinical follow-up was obtained at I year. Procedural success (defined as a residual Stenosis <30%) Was recorded; as Was the 1-year incidence of myocardial infarction (MI), stent thrombosis (ST) and major adverse cardiac events (MACE), a composite end point of cardiac death, MI or target lesion revascularization (TLR). Eighty-five patients underwent RA followed by stenting, 30 receiving a BMS and 55,a DES, and completed 1-year clinical follow-up. Baseline clinical and angiographic characteristics were similar, and procedural success was achieved in 99% of the Patients. All year the overall incidence of MACE was 19%, and no significant differences in clinical outcome between DES and BMS were seen (MACE:, (16%) vs 7 (23%), P = 0.44; cardiac death: 3(5%) vs 0 (0%); MI: 4 (7%) vs 5 (17%), P = 0.2; TLR: 2(4%) vs 3(10%), P = 0.25; ST: 2(4%) vs 2 (7%), P = 0.52, respectively). Conclusions In this study, no significant differences in medium-term clinical outcomes between DES and BMS after RA were observed, although, there was a definite trend to improved outcomes with DES.