January 2nd, 2024

In the field of Interventional Cardiology, various studies have been conducted to assess different techniques and their outcomes in treating cardiovascular conditions. One such study in the domain of Percutaneous Coronary Intervention (PCI) focused on comparing mid-term outcomes among different treatments for femoropopliteal arterial occlusion. This retrospective cohort study involved 321 patients who were treated with either a bare metal stent (BMS), drug-coated balloon (DCB) alone, a combination of atherectomy and drug-coated balloon (AT+DCB), or atherectomy (AT) alone. The results indicated that the restenosis rate varied among these methods, with BMS showing a 21% rate, AT alone at 24.6%, DCB alone at 10.1%, and AT+DCB at 11.5%. The primary patency rates at 24 months were 77.7% for BMS, 89.4% for DCB alone, 88.0% for AT+DCB, and 73.7% for AT alone. These findings suggest that AT+DCB and DCB alone are associated with higher primary patency, indicating a preference for these methods in treating femoropopliteal lesions (1).

Another area of interest is the staging of PCI in Acute Coronary Syndrome (ACS). A cohort study was conducted with patients who had ACS and were scheduled for out-of-hospital non-TV staged PCI. The intervention in focus was the quantitative flow ratio (QFR). Among 1093 patients out of 1432 eligible participants, the study found that QFR did not independently predict non-TV events before the planned staged PCI. This outcome suggests that QFR may not be effective in refining the timing of staged PCI in patients with ACS (2).

Lastly, the effectiveness of Rotational Atherectomy (RA) in Chronic Total Occlusions (CTO) was evaluated through a systematic review and meta-analysis. This study included 7 different research works, encompassing a total of 5494 patients. The comparison was between RA and conventional Percutaneous Coronary Intervention (PCI). The results showed that RA was comparable to PCI in decreasing the incidence of major adverse cardiac events (MACE), with an odds ratio of 0.98 and a 95% confidence interval of 0.74 to 1.3 (p = 0.9). There was no significant difference in clinical or angiographic outcomes observed between the two methods. This indicates that RA offers similar outcomes to conventional PCI for CTO lesions, providing interventional cardiologists with an expanded perspective for addressing calcified lesions (3).

1. Yang L, Quan J, Dong J, Ding N, Han Y, Cong L, et al. Comparison of mid-outcome among bare metal stent, atherectomy with or without drug-coated balloon angioplasty for femoropopliteal arterial occlusion. Sci Rep. 2024;14(1):63.

2. Bär S, Kavaliauskaite R, Otsuka T, Ueki Y, Häner J, Lanz J, et al. Quantitative Flow Ratio to Predict Non-Target-Vessel Events Before Planned Staged Percutaneous Coronary Intervention in Patients With Acute Coronary Syndrome. J Am Heart Assoc. 2024;13(1):e031847.

3. Abdelaziz A, Elsayed H, Hamdaalah A, Atta K, Mechi A, Kadhim H, et al. Safety and feasibility of rotational atherectomy (RA) versus conventional stenting in patients with chronic total occlusion (CTO) lesions: a systematic review and meta-analysis. BMC Cardiovasc Disord. 2024;24(1):4.