AI Article Synopsis
- Researchers evaluated the safety and effectiveness of a saline solution with heparin for patients undergoing rotational atherectomy, an effective procedure for treating calcified plaque.
- The study included 67 patients, achieving a 100% procedural success rate, but reported some cases of hypotension and minor complications like slow flow.
- The findings suggest that this heparin-saline solution could be a viable alternative to traditional solutions containing RotaGlide, nitroglycerin, and verapamil, which can cause more significant hemodynamic issues.
Article Abstract
Unlabelled: We assessed the feasibility and safety of a rota-flush solution with 10,000 U of unfractionated heparin in 1 L of normal saline in patients who underwent rotational atherectomy.
Background: Rotational atherectomy with the Rotablator (Boston Scientific) rotational atherectomy system is an effective way to modify severely calcified plaque. Potential complications include coronary spasm and slow-flow/no-flow. A pressured rota-flush solution is infused into the device to lubricate the drive shaft to minimize the risk of these complications as well as facilitate delivery of the device. RotaGlide lubricant (Boston Scientific), which decreases the friction between the drive shaft and RotaWire (Boston Scientific), is routinely added to the rota-flush solution. Antispasmotic agents including nitroglycerin and verapamil are commonly added to the rota-flush solution, but can lead to hemodynamic disturbances like hypotension and bradycardia.
Methods: A total of 67 consecutive patients who underwent rotational atherectomy from July 2012 to June 2015 were included in this analysis. The primary endpoint was procedural success.
Results: Procedural success was achieved in all patients. Significant hypotension occurred in 6%. No patients developed severe bradycardia requiring emergent insertion of a transvenous pacemaker. Major adverse cardiac and cerebral events occurred in 6.0%, all due to non-fatal myocardial infarction. Slow/no flow occurred in 7%, with subsequent resolution after intracoronary vasodilator therapy. Coronary spasm occurred in 4%. Stent thrombosis, perforation, flow-limiting dissection, and stent loss were not observed.
Conclusion: A rota-flush solution with 10,000 U of unfractionated heparin in 1 L of normal saline is a reasonable alternative to the routinely used solution which includes the RotaGlide lubricant, nitroglycerin, and verapamil.
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Background: Rotational atherectomy (RA) may cause bradyarrhythmias and transitory atrioventricular block when performed in the right coronary artery (RCA) or a dominant circumflex (CX) coronary artery. However, there are no studies of a solution that can prevent coronary flow deterioration and bradycardia complications that may occur during RA. We aimed to create an alternative rota-flush solution to minimize the risk of bradycardia and complete atrioventricular block (AVB) that can occur during RA.
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Article Synopsis
- A study was conducted to evaluate the safety and effectiveness of a heparin rota-flush (OHRF) solution compared to an alternative rota-flush (ARF) solution during rotational atherectomy (RA) procedures.
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Introduction: The efficacy of heparin based flush solutions in rotational atherectomy (RA) has not been validated. Recently, a single center study demonstrated the feasibility of an alternative flush solution with 10,000U of unfractionated heparin (UFH) in 1L of normal saline. We aimed to evaluate the safety and efficacy of an alternative flush solution intermittently utilized at our institution.
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100 Medical Plaza Suite 630, Los Angeles, CA 90095 USA.
Article Synopsis
- Researchers evaluated the safety and effectiveness of a saline solution with heparin for patients undergoing rotational atherectomy, an effective procedure for treating calcified plaque.
- The study included 67 patients, achieving a 100% procedural success rate, but reported some cases of hypotension and minor complications like slow flow.
- The findings suggest that this heparin-saline solution could be a viable alternative to traditional solutions containing RotaGlide, nitroglycerin, and verapamil, which can cause more significant hemodynamic issues.
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