TCT-576 The Impact of Atherectomy in Severely Calcified Lesions in Patients With Impella-Supported High-Risk Percutaneous Coronary Intervention: Insights From the cVAD PROTECT III Study
Recommended Citation
Falah B, Zhao D, Thompson J, Basir MB, Moses J, Redfors B, Schonning M, O’Neill W, Wollmuth J. TCT-576 The Impact of Atherectomy in Severely Calcified Lesions in Patients With Impella-Supported High-Risk Percutaneous Coronary Intervention: Insights From the cVAD PROTECT III Study. J Am Coll Cardiol 2024; 84(18):B210-B211.
Document Type
Conference Proceeding
Publication Date
10-29-2024
Publication Title
J Am Coll Cardiol
Abstract
Background: Severely calcified coronary lesions lead to worse patient outcomes. Atherectomy is often used to treat these lesions, but there are limited data on outcomes for patients receiving Impella (Abiomed)-supported high-risk percutaneous coronary intervention (HRPCI). Methods: Patients in the cVAD PROTECT III study (NCT04136392) were stratified into groups: severe calcification who underwent atherectomy, severe calcification who did not undergo atherectomy, and nonsevere calcification. Calcification severity was dictated by an independent quantitative coronary angiography core lab based on angiographic radiopacities. Major adverse cardiovascular and cerebrovascular events (composite of all-cause death, myocardial infarction, stroke/transient ischemic attack, and repeat revascularization) were assessed at 30 and 90 days (Figure). Results: Of 1,015 patients, 28.5% had severe calcification without atherectomy, 32.1% had severe calcification with atherectomy, and 39.4% had nonsevere calcification. Intravascular imaging was used in 54.6% of cases with severe calcification undergoing atherectomy. At 90 days, severe calcification without atherectomy had higher major adverse cardiovascular and cerebrovascular event rates compared to the other groups. However, adjusted multivariable analysis found no significant difference at 90 days in severe calcification with atherectomy vs severe calcification without atherectomy (HR: 0.76; 95% CI: 0.48-1.22; P = 0.25) or nonsevere calcification vs severe calcification without atherectomy (HR: 0.62; 95% CI: 0.38-1.00; P = 0.051). [Formula presented] Conclusion: Impella-supported HRPCI with atherectomy for severe calcification has comparable short-term safety and efficacy as Impella-supported HRPCI without atherectomy. Categories: CORONARY: Complex and Higher Risk Procedures for Indicated Patients (CHIP).
Volume
84
Issue
18
First Page
B210
Last Page
B211
