Temporal Trends and Prognosis in Rotational Atherectomy: A Comparison of Contemporary and Traditional Eras
5 affiliations
- 1Cardiology Department Hospital Clínico San Carlos, IdISSC Madrid Spain
- 2Centro Nacional de Investigaciones Cardiovasculares (CNIC) Instituto de Salud Carlos III Madrid Spain
- 3Research Methodological Support Unit Hospital Clínico San Carlos, IdISSC Madrid Spain
- 4Cardiology Department Hospital Universitario de Torrejón, Ribera Salud Group Madrid Spain
- 5Department of Medicine Faculty of Medicine, Health and Sports, Universidad Europea de Madrid Madrid Spain
Abstract
Background: Rotational atherectomy (RA) has undergone considerable technical modernization in recent years. This study evaluated whether RA performed in the contemporary era was associated with superior cardiovascular outcomes compared with the traditional era.
Aims: To compare the clinical characteristics and cardiovascular outcomes of patients treated with contemporary versus traditional rotational atherectomy, reflecting the evolution of clinical practice over time.
Methods: We employed a registry including patients from April 2004 to December 2020. Group allocation was determined through a cluster analysis based on three variables reflecting temporal changes in RA practice: vascular access, sheath size, and burr diameter, yielding a traditional cohort (n = 290; procedures before May 2011) and a contemporary cohort (n = 279; procedures from May 2011). Comparisons between groups were performed to assess for statistically and clinically relevant prognostic differences. Multivariable analyses were performed to adjust for baseline imbalances.
Results: Patients treated in the contemporary cohort exhibited lower left ventricular ejection fraction (LVEF) and worse Killip class. Their RA procedures were longer, required less contrast, and made substantially greater use of intracoronary imaging than those in the traditional cohort. Statin therapy and potent P2Y12 inhibitors were prescribed more frequently in the contemporary cohort. On follow‐up, contemporary practice yielded fewer reinfarctions and fewer target‐lesion and target‐vessel revascularizations, but a higher incidence of clinically relevant bleeding. Cardiovascular and all‐cause mortality were comparable between both eras. These differences persisted after multivariable adjustment for baseline imbalances.
Conclusions: Contemporary RA was associated with fewer reinfarctions and revascularizations, which persisted after multivariable adjustment. Despite including patients with lower LVEF and a more critical status, no differences were detected in all‐cause mortality.
Related
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BibTeX
@article{vazirani2026temporal,
title = {{Temporal Trends and Prognosis in Rotational Atherectomy: A Comparison of Contemporary and Traditional Eras}},
author = {Ravi Vazirani and Gonzalo García‐Martí and Andrés Provencio‐Regidor and Irene Serrano‐García and Adrián Jerónimo‐Baza and Alejandro Travieso and Gabriela Tirado‐Conte and Fernando Macaya‐Ten and Hernán Mejía‐Rentería and Pablo Salinas and Luis Nombela‐Franco and Pilar Jiménez‐Quevedo and Nieves Gonzalo and Javier Escaned and Antonio Fernández‐Ortiz and Iván J. Núñez‐Gil},
journal = {Catheterization and Cardiovascular Interventions},
year = {2026},
month = sep,
doi = {10.1002/ccd.70846},
url = {https://doi.org/10.1002/ccd.70846},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Temporal Trends and Prognosis in Rotational Atherectomy: A Comparison of Contemporary and Traditional Eras
AU - Ravi Vazirani
AU - Gonzalo García‐Martí
AU - Andrés Provencio‐Regidor
AU - Irene Serrano‐García
AU - Adrián Jerónimo‐Baza
AU - Alejandro Travieso
AU - Gabriela Tirado‐Conte
AU - Fernando Macaya‐Ten
AU - Hernán Mejía‐Rentería
AU - Pablo Salinas
AU - Luis Nombela‐Franco
AU - Pilar Jiménez‐Quevedo
AU - Nieves Gonzalo
AU - Javier Escaned
AU - Antonio Fernández‐Ortiz
AU - Iván J. Núñez‐Gil
PY - 2026
DA - 2026/09/06
JO - Catheterization and Cardiovascular Interventions
DO - 10.1002/ccd.70846
UR - https://doi.org/10.1002/ccd.70846
AB - Background: Rotational atherectomy (RA) has undergone considerable technical modernization in recent years. This study evaluated whether RA performed in the contemporary era was associated with superior cardiovascular outcomes compared with the traditional era. Aims: To compare the clinical characteristics and cardiovascular outcomes of patients treated with contemporary versus traditional rotational atherectomy, reflecting the evolution of clinical practice over time. Methods: We employed a registry including patients from April 2004 to December 2020. Group allocation was determined through a cluster analysis based on three variables reflecting temporal changes in RA practice: vascular access, sheath size, and burr diameter, yielding a traditional cohort (n = 290; procedures before May 2011) and a contemporary cohort (n = 279; procedures from May 2011). Comparisons between groups were performed to assess for statistically and clinically relevant prognostic differences. Multivariable analyses were performed to adjust for baseline imbalances. Results: Patients treated in the contemporary cohort exhibited lower left ventricular ejection fraction (LVEF) and worse Killip class. Their RA procedures were longer, required less contrast, and made substantially greater use of intracoronary imaging than those in the traditional cohort. Statin therapy and potent P2Y12 inhibitors were prescribed more frequently in the contemporary cohort. On follow‐up, contemporary practice yielded fewer reinfarctions and fewer target‐lesion and target‐vessel revascularizations, but a higher incidence of clinically relevant bleeding. Cardiovascular and all‐cause mortality were comparable between both eras. These differences persisted after multivariable adjustment for baseline imbalances. Conclusions: Contemporary RA was associated with fewer reinfarctions and revascularizations, which persisted after multivariable adjustment. Despite including patients with lower LVEF and a more critical status, no differences were detected in all‐cause mortality.
SN - 1522-1946
SN - 1522-726X
ER -