Increase in vessel luminal diameter after rotational atherectomy: a study from multan institute of cardiology, pakistan

Authors

  • Momin Rasheed CPEIC, Multan, Pakistan
  • Badar Ul Ahad Gill CPEIC, Multan, Pakistan
  • M. Ikram Farid CPEIC, Multan, Pakistan
  • Mubashir Sherwani CPEIC, Multan, Pakistan
  • Muhammad Shahzad Fareed CPEIC, Multan, Pakistan
  • Masood Ahmad Khan CPEIC Multan, Pakistan

DOI:

https://doi.org/10.61581/mjsp.v6i02.339

Keywords:

Rotablation, Rotational Atherectomy, Rotational Angioplasty, Luminal Diameter, Vessel Diameter

Abstract

Objective: To determine the increase in vessel luminal diameter in patients undergoing rotational atherectomy at Multan Institute of Cardiology, Pakistan.

Material and Methods: A descriptive study enrolled 100 patients undergoing rotational atherectomy at Multan Institute of Cardiology, Pakistan. After baseline characteristics, the pre- and post-procedural minimal luminal diameter and reference vessel diameter were recorded. The change in luminal diameter was recorded in terms of mean and standard deviation. We stratified the data, applied a post-stratification t-test, and considered a p-value of less than 0.05 as significant. 

Results: The mean age was 52.20 ± 11.19 years, with more male (76.0%) patients. Risk factors included hypertension (45.0%), smoking (40.0%), diabetes (34.0%), and hyperlipidemia (32.0%). Lesions most frequently involved was the left anterior descending artery (LAD: 55.0%), with mid-distal location (65.0%) and severe calcification (71.0%). The minimal lumen diameter (MLD) significantly increased from pre-procedure and post-procedure 0.75?±?0.14?mm to 1.88?±?0.22?mm (p?<?0.001). At the same time, the mean luminal gain was 1.13±0.026?mm. The luminal gain with relation to reference diameter was 46%.

Conclusion: Rotational atherectomy can lead to significant luminal gain with remarkable procedural success.

Downloads

Download data is not yet available.

Author Biographies

  • Badar Ul Ahad Gill, CPEIC, Multan, Pakistan

    Associate Professor of Cardiology

    Department of Cardiology

  • M. Ikram Farid, CPEIC, Multan, Pakistan

    Associate Professor of Cardiology

    Department of Cardiology

  • Mubashir Sherwani, CPEIC, Multan, Pakistan

    Associate Professor of Cardiology

    Department of Cardiology

  • Muhammad Shahzad Fareed, CPEIC, Multan, Pakistan

    Assistant Professor of Cardiology

    Department of Cardiology

References

1. Shi X, Gao J, Lv Q, Cai H, Wang F, Ye R, et al. Calcification in atherosclerotic plaque vulnerability: Friend or foe? Front Physiol. 2020;11:56. Available from: http://dx.doi.org/10.3389/fphys.2020.00056

2. Sugane H, Kataoka Y, Otsuka F, Nakaoku Y, Nishimura K, Nakano H, et al. Cardiac outcomes in patients with acute coronary syndrome attributable to calcified nodule. Atherosclerosis. 2021;318:70–5. Available from: http://dx.doi.org/10.1016/j.atherosclerosis.2020.11.005

3. Graby J, Soto-Hernaez J, Murphy D, Oldman JLAF, Burnett TA, Charters PFP, et al. Coronary artery calcification on routine CT has prognostic and treatment implications for all ages. Clin Radiol. 2023 Jun;78(6):412-420. doi: 10.1016/j.crad.2023.02.007.

4. Yi B, Zeng W, Lv L, Hua P. Changing epidemiology of calcific aortic valve disease: 30-year trends of incidence, prevalence, and deaths across 204 countries and territories. Aging (Albany NY). 2021;13(9):12710–32. Available from: http://dx.doi.org/10.18632/aging.202942

5. Khattak S, Sharma H, Khan SQ. Atherectomy techniques: Rotablation, orbital and laser. Interv Cardiol. 2024;19:e21. Available from: http://dx.doi.org/10.15420/icr.2024.16

6. Barbato E, Gallinoro E, Abdel-Wahab M, Andreini D, Carrié D, Di Mario C, et al. Management strategies for heavily calcified coronary stenoses: an EAPCI clinical consensus statement in collaboration with the EURO4C-PCR group. Eur Heart J. 2023;44(41):4340–56. Available from: http://dx.doi.org/10.1093/eurheartj/ehad342

7. Allali A, Abdel-Wahab M, Elbasha K, Mankerious N, Traboulsi H, Kastrati A, et al. Rotational atherectomy of calcified coronary lesions: current practice and insights from two randomized trials. Clin Res Cardiol. 2023;112(9):1143–63. Available from: http://dx.doi.org/10.1007/s00392-022-02013-2

8. Sharma V, Abdul F, Haider ST, Din J, Talwar S, O’kane P, et al. Rotablation in the very elderly-safer than we think? Cardiovascular Revascularization Medicine. 2021;22:36–41.

9. Maier A, Gissler MC, Jäckel M, Oettinger V, Bacmeister L, Heidenreich A, et al. Procedural safety of rotational atherectomy and modified balloon angioplasty: insights from a German national registry. Clin Res Cardiol. 2024; Available from: http://dx.doi.org/10.1007/s00392-024-02538-8

10. Xu J, Wang YW, Ma LK, Hu H, Chen HW, Hua JS, et al. Safety and efficacy of different rotational speed during rotational atherectomy in coronary heart disease patients (RACE): study protocol for a randomized controlled trial. Trials. 2025;26(1):126. Available from: http://dx.doi.org/10.1186/s13063-025-08834-6

11. Imtiaz S, Ahmed DS, Tariq DS, Chughtai DJ, Saeed DF, Memon S, et al. Vascular Calcification in maintenance Hemodialysis patients in Pakistan – A single center Cross-sectional study. Pak J Kidney Dis. 2022;6(4):16–25. Available from: http://dx.doi.org/10.53778/pjkd64208

12. Khan BK, Faheem O, Rahman MN. Characteristics and outcomes of rotational atherectomy in a tertiary care cardiology facility in Pakistan. Pak Hear J. 2021 [cited 2025 May 7];54(3):214–8. Available from: https://www.pakheartjournal1.pcs.org.pk/index.php/pk/article/view/2166

13. Tomasiewicz B, Kubler P, Zimoch W, Kosowski M, Wańha W, Ładziński S, et al. Acute angulation and sequential lesion increase the risk of rotational atherectomy failure. Circ J. 2021;85(6):867–76. Available from: http://dx.doi.org/10.1253/circj.CJ-20-1222

14. Blachutzik F, Meier S, Weissner M, Schlattner S, Gori T, Ullrich-Daub H, et al. Comparison of coronary intravascular lithotripsy and rotational atherectomy in the modification of severely calcified stenoses. Am J Cardiol. 2023;197:93–100. Available from: http://dx.doi.org/10.1016/j.amjcard.2023.02.028

15. Khan S, Shah SHA, Basir W. Patterns of coronary artery occlusion in acute coronary syndrome patients undergoing coronary angiography in a cardiac center of a low-middle income country. Pak Hear J. 2025;58(1):73–8. Available from: http://dx.doi.org/10.47144/phj.v58i1.2856

16. Hemetsberger R, Mankerious N, Muntané-Carol G, Temporal J, Sulimov D, Gaede L, et al. In-hospital outcomes of rotational atherectomy in ST-elevation myocardial infarction: Results from the multicentre ROTA-STEMI network. Can J Cardiol. 2024;40(7):1226–33. Available from: http://dx.doi.org/10.1016/j.cjca.2023.12.018

17. Mahorkar A, Mahorkar V, Mahorkar A, Mahorkar U, Namdeo T, Sarwale S, et al. Comparative Outcomes of Rota Ablation in Calcific Coronary Lesions: Impact of SYNTAX Score, LV Dysfunction and Imaging vs. Non-Imaging-Guided PCI-A Single-Centre Experience from Central India. Journal of Cardiovascular Disease Research. 2024;15(11):278–91.

18. Khan MI, Naseem M, Khalil MSUD, Yar A, Khan MR, Orakzai MH. Correlation between duration of diabetes and severity of coronary artery disease in patients undergoing coronary angiography at a tertiary care hospital. Pak Hear J. 2024;57(4):329–36. Available from: http://dx.doi.org/10.47144/phj.v57i4.2808

19. Sakakura K, Taniguchi Y, Yamamoto K, Tsukui T, Jinnouchi H, Seguchi M, et al. Modifiable and unmodifiable factors associated with slow flow following rotational atherectomy. PLoS One. 2021;16(4):e0250757. Available from: http://dx.doi.org/10.1371/journal.pone.0250757

20. Chen YW, Lai CH, Su CS, Chang WC, Wang CY, Chen WJ, et al. The procedural and clinical outcomes of rotational atherectomy in patients presenting with acute myocardial infarction. Front Cardiovasc Med. 2022;9:846564. Available from: http://dx.doi.org/10.3389/fcvm.2022.846564

21. Khan AA, Murtaza G, Khalid MF, White CJ, Mamas MA, Mukherjee D, et al. Outcomes of rotational atherectomy versus orbital atherectomy for the treatment of heavily calcified coronary stenosis: A systematic review and meta-analysis. Catheter Cardiovasc Interv. 2021;98(5):884–92. Available from: http://dx.doi.org/10.1002/ccd.29430

22. Ayoub M, Corpataux N, Behnes M, Schupp T, Forner J, Akin I, et al. Safety and efficiency of rotational atherectomy in chronic total coronary occlusion-one-year clinical outcomes of an observational registry. J Clin Med. 2023;12(10). Available from: http://dx.doi.org/10.3390/jcm12103510

23. Sayegh M, Proczka M, Mancuso D, Huntress L, Savarese J, Ricotta J, et al. Effects of atherectomy on immediate luminal gain in patients with in-stent restenosis (ISR) with or without Stent thrombosis. J Vasc Surg. 2024;79(6):e178. Available from: http://dx.doi.org/10.1016/j.jvs.2024.03.223

24. Farhat H, Kuzemczak M, Durel N, Caillot N, Pawłowski T, Lipiecki J. Rotational atherectomy versus intravascular lithotripsy for calcified in-Stent restenosis: A single-center study with 1-year follow-up. Am J Cardiol. 2023;205:413–9. Available from: http://dx.doi.org/10.1016/j.amjcard.2023.07.174

Published

30-06-2024

How to Cite

Increase in vessel luminal diameter after rotational atherectomy: a study from multan institute of cardiology, pakistan. (2024). Medical Journal of South Punjab, 6(02). https://doi.org/10.61581/mjsp.v6i02.339