open access

Vol 76, No 11 (2018)
EXPERTS’ OPINIONS AND POSITION PAPERS
Published online: 2018-11-16
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Rotational atherectomy in everyday clinical practice. Association of Cardiovascular Interventions of the Polish Society of Cardiology (Asocjacja Interwencji Sercowo-Naczyniowych Polskiego Towarzystwa Kardiologicznego — AISN PTK): Expert opinion

Sławomir Dobrzycki, Krzysztof Reczuch, Jacek Legutko, Tomasz Pawłowski, Marek Grygier, Andrzej Ochała, Jarosław Wójcik, Paweł Buszman, Dariusz Dudek, Mariusz Gąsior, Robert Gil, Maciej Lesiak, Krzysztof Kukuła, Adam Witkowski, Wojciech Zajdel, Paweł Kralisz, Wojciech Wojakowski, Stanisław Bartuś
DOI: 10.5603/KP.2018.0225
·
Kardiol Pol 2018;76(11):1576-1584.

open access

Vol 76, No 11 (2018)
EXPERTS’ OPINIONS AND POSITION PAPERS
Published online: 2018-11-16

Abstract

The common use of stents, including antiproliferative drug-eluting stents, has been a major breakthrough in invasive cardiology. Nowadays, a change in the clinical presentation of patients treated with percutaneous coronary intervention (PCI) is observed. The typical clinical characteristics now include advanced age, diabetes, chronic kidney disease, heart failure, and multilevel atherosclerosis. Age, diabetes, and chronic kidney disease are the main predictors of coronary artery calcifications. Severe coronary artery calcifications are the main factor limiting the efficacy of PCI. Successful stent implantation is challenging in the presence of calcifications, because it is difficult to achieve full stent expansion and proper stent apposition. Therefore, it is necessary to adequately prepare the lesion before stent implantation. This document presents the technique of rotational atherectomy (rotablation) as well as indications for and contraindications to the procedure, along with its possible complications and their prevention. Training in rotablation for operators as well as reimbursement policy for the procedure in Poland are also discussed.

Abstract

The common use of stents, including antiproliferative drug-eluting stents, has been a major breakthrough in invasive cardiology. Nowadays, a change in the clinical presentation of patients treated with percutaneous coronary intervention (PCI) is observed. The typical clinical characteristics now include advanced age, diabetes, chronic kidney disease, heart failure, and multilevel atherosclerosis. Age, diabetes, and chronic kidney disease are the main predictors of coronary artery calcifications. Severe coronary artery calcifications are the main factor limiting the efficacy of PCI. Successful stent implantation is challenging in the presence of calcifications, because it is difficult to achieve full stent expansion and proper stent apposition. Therefore, it is necessary to adequately prepare the lesion before stent implantation. This document presents the technique of rotational atherectomy (rotablation) as well as indications for and contraindications to the procedure, along with its possible complications and their prevention. Training in rotablation for operators as well as reimbursement policy for the procedure in Poland are also discussed.

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Keywords

atherectomy; rotablation; percutaneous coronary angioplasty; coronary heart disease

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Title

Rotational atherectomy in everyday clinical practice. Association of Cardiovascular Interventions of the Polish Society of Cardiology (Asocjacja Interwencji Sercowo-Naczyniowych Polskiego Towarzystwa Kardiologicznego — AISN PTK): Expert opinion

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 76, No 11 (2018)

Pages

1576-1584

Published online

2018-11-16

DOI

10.5603/KP.2018.0225

Bibliographic record

Kardiol Pol 2018;76(11):1576-1584.

Keywords

atherectomy
rotablation
percutaneous coronary angioplasty
coronary heart disease

Authors

Sławomir Dobrzycki
Krzysztof Reczuch
Jacek Legutko
Tomasz Pawłowski
Marek Grygier
Andrzej Ochała
Jarosław Wójcik
Paweł Buszman
Dariusz Dudek
Mariusz Gąsior
Robert Gil
Maciej Lesiak
Krzysztof Kukuła
Adam Witkowski
Wojciech Zajdel
Paweł Kralisz
Wojciech Wojakowski
Stanisław Bartuś

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