Clinical Application Of Percutaneous Coronary Rotational Atherectomy In Coronary Artery Calcification Lesions

Background and Objective:In recent years, with the development of society and people’s livingstandard continues to improve, people’s lifestyle and diet occurred importantchanges, coupled with an aging population phenomenon, so that patients withcoronary heart disease is far more than the number of before.Coronary heartdisease is a serious threat to the life and health and quality of life.It is one of theleading causes of death in our middle-aged. The treatment of percutaneouscoronary intervention (PCI) of coronary heart disease is the most important oneof the treatment.Coronary artery calcification was the difficulty of the PCItreatment in severe calcified lesions.It is one of the main factors leading to thePCI surgery failed.Some serious calcified lesions is difficult to pass the balloonwhich can not expand or stent, or stent implantation. Although stentmalapposition can easily be expanded,it always can lead to coronary in-stentrestenosis and subacute thrombosis. After the internal rotation percutaneouscoronary angioplasty (PTCRA) is one of the more important auxiliary methodof percutaneous coronary intervention, PTCRA combined with PCI was thetreatment of coronary artery calcification that can significantly improve thesuccess rate of surgery for coronary intervention. However, PTCRA istechnically complex operation,and it can prone to serious complications[1].We analyzed and summarized the PTCRA in our hospital in the past two yearsto investigate the effectiveness and safety of the treatment of coronary arterycalcification.Methods:We selected patients from February2011to November2012a total of22 months in our hospital for coronary heart disease patients who treated with PCI,according to whether the line use PTCRA randomly divided into PTCRAgroups and non-PTCRA group.They were all given the relevant laboratoryexaminations after admission.Before surgery，they were given oral loading doseof aspirin enteric-coated tablets300mg and clopidogrel300mg or600mg.Application of the Seldinger law puncture right radial artery and the rightfemoral artery for coronary angiography. coronary artery calcification andcoronary artery diameter reduction of≥70%is the treatment standard ofPTCRA. We observed in patients with coronary artery calcification situation,the success rate of surgery and perioperative complications. All the patients afterregular use of aspirin, clopidogrel, lipid-lowering drugs, and other drugs,according to the patient’s specific situation plus. We telephone them tofollow-up each month for12months. Inqiring them if they have angina attack,major cardiovascular events including cardiac death, myocardial infarction, andtarget lesion revascularization occurred. After6-12months,we suggestedthem to review coronary angiography.Results:There are33calcified lesions at the accepted PTCRA surgerytreatment.The success rate was96.88%. There are a total of74stentimplantation combined with percutaneous coronary interventional therapy (PCI).There is no acute myocardial infarction, cardiac death, complications ofcoronary perforation, bleeding and emergency coronary artery bypass grafting(CABG).1patient of PTCRA group had cardiac arrest, and one patient occurredventricular fibrillation,they all to restore sinus rhythm after the appropriatedrugs treatment.After12months of following-up,there is no cases of recurrentangina and major cardiovascular events.Conclusion:PTCRA combined with the PCI treatment has a good safety andeffectiveness in the coronary calcification recent treatment. The long-termeffectiveness is also good.