Objectives
The purpose of this randomized trial was to compare the incidence of slow flow between low‐speed and high‐speed rotational atherectomy (RA) of calcified coronary lesions.
Background
Preclinical studies suggest that slow flow is less frequently observed with low‐speed than high‐speed RA because of less platelet aggregation with low‐speed RA.
Methods
This was a prospective, randomized, single center study. A total of 100 patients with calcified coronary lesions were enrolled and randomly assigned in a 1:1 ratio to low‐speed (140,000 rpm) or high‐speed (190,000 rpm) RA. The primary endpoint was the occurrence of slow flow following RA. Slow flow was defined as slow or absent distal runoff (Thrombolysis in Myocardial Infarction [TIMI] flow grade ≤ 2).
Results
The incidence of slow flow in the low‐speed group (24%) was the same as that in the high‐speed group (24%) (P = 1.00; odds ratio, 1.00; 95% confidence interval, 0.40–2.50). The frequencies of TIMI 3, TIMI 2, TIMI 1, and TIMI 0 flow grades were similar between the low‐speed (TIMI 3, 76%; TIMI 2, 14%; TIMI 1, 8%; TIMI 0, 2%) and high‐speed (TIMI 3, 76%; TIMI 2, 14%; TIMI 1, 10%; TIMI 0, 0%) groups (P = 0.77 for trend). The incidence of periprocedural myocardial infarction was the same between the low‐speed (6%) and high‐speed (6%) groups (P = 1.00).
Conclusions
This randomized trial did not show a reduction in the incidence of slow flow following low‐speed RA as compared with high‐speed RA (UMIN ID: UMIN000015702). © 2016 Wiley Periodicals, Inc.