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Combined use of rotational and excimer lASER coronary atherectomy (RASER) during complex coronary angioplasty—An analysis of cases (2006–2016) from the British Cardiovascular Intervention Society database

Lookup NU author(s): Dr Mohaned Egred

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Abstract

© 2020 Wiley Periodicals LLC. Introduction: Combining rotational (RA) and excimer laser coronary atherectomy (ELCA)—RASER atherectomy—is technique utilized in the percutaneous management of calcific coronary disease. The evidence base examining its safety and utility is sparse and limited to small case-series. This study examines the patterns and outcomes of RASER atherectomy use in the largest cohort to date. Methods: Using the British Cardiac Intervention Society database, data were analyzed on all PCI procedures in the UK between 2006 and 2016. Descriptive statistics and multivariate logistic regressions were used to examine baseline, procedural, and outcome associations with RASER. Results: We identified 153 (0.02%) RASER atherectomy cases out of 686,358 PCI procedures. Baseline covariates associated with RASER use were age, BMI, diabetes, stable coronary disease, and previous CABG. Procedural co-variates associated with RASER were CTO-PCI, the use of more/longer stents, intravascular imaging, cutting balloons, and microcatheters. Adjusted rates of in-hospital major adverse cardiac/cerebrovascular events (MACCE) were not significantly different with RASER. However, there were higher odds of arterial complications (OR 3.23, 95% CI: 1.58–6.61), slow flow (OR 3.50, 95% CI: 1.29–9.55), and shock induction (OR 9.66, 95% CI: 3.44–27.06). Conclusions: RASER atherectomy use in complex PCI is associated with higher risk baseline and procedural characteristics. Although increased rates of shock induction, slow flow, and arterial complications were observed, RASER does not increase the likelihood of in-hospital MACCE, major bleeding, or death.

Publication metadata

Author(s): Protty MB, Gallagher S, Farooq V, Sharp ASP, Egred M, O'Kane P, Kinnaird T

Publication type: Article

Publication status: Published

Journal: Catheterization and Cardiovascular Interventions

Year: 2021

Volume: 97

Issue: 7

Pages: E911-E918

Print publication date: 01/06/2021

Online publication date: 17/11/2020

Acceptance date: 22/10/2020

ISSN (print): 1522-1946

ISSN (electronic): 1522-726X

Publisher: John Wiley and Sons Inc.

URL: https://doi.org/10.1002/ccd.29377

DOI: 10.1002/ccd.29377

PubMed id: 33201601

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