Clinical expert consensus document on rotational atherectomy from the Japanese association of cardiovascular interventio
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EXPERT CONSENSUS DOCUMENT
Clinical expert consensus document on rotational atherectomy from the Japanese association of cardiovascular intervention and therapeutics Kenichi Sakakura1 · Yoshiaki Ito2 · Yoshisato Shibata3 · Atsunori Okamura4 · Yoshifumi Kashima5 · Shigeru Nakamura6 · Yuji Hamazaki7 · Junya Ako8 · Hiroyoshi Yokoi9 · Yoshio Kobayashi10 · Yuji Ikari11 Received: 15 August 2020 / Accepted: 15 August 2020 © Japanese Association of Cardiovascular Intervention and Therapeutics 2020
Abstract Rotational atherectomy (RA) has been widely used for percutaneous coronary intervention (PCI) to severely calcified lesions. As compared to other countries, RA in Japan has uniquely developed with the aid of greater usage of intravascular imaging devices such as intravascular ultrasound (IVUS) or optical coherence tomography (OCT). IVUS has been used to understand the guidewire bias and to decide appropriate burr sizes during RA, whereas OCT can also provide the thickness of calcifica‑ tion. Owing to such abundant experiences, Japanese RA operators modified RA techniques and reported unique evidences regarding RA. The Task Force on Rotational Atherectomy of the J apanese Association of Cardiovascular Intervention and Therapeutics (CVIT) has now proposed the expert consensus document to summarize the contemporary techniques and evidences regarding RA. Keywords Rotational atherectomy · Calcification · Percutaneous coronary intervention · Intravascular ultrasound · Optical coherence tomography.
Introduction Severe calcification in atherosclerotic plaques has been the most common cause of poor clinical outcomes since the beginning of percutaneous coronary intervention (PCI) [1, 2]. Rotational atherectomy (RA) has been widely used for severely calcified coronary lesions for more than 20 years to improve clinical outcomes in patients with severely calcified * Kenichi Sakakura [email protected] 1
lesions. Recently, North American expert review as well as European expert consensus on RA have been published to provide a clinical standard for RA operators [3, 4]. As compared to North America and European countries, RA in Japan has uniquely developed with the aid of greater usage of intravascular imaging devices [5, 6]. Since the cost of intravascular ultrasound (IVUS) or optical coherence tomog‑ raphy (OCT) during percutaneous coronary intervention 6
Cardiovascular center, Kyoto Katsura Hospital, Kyoto, Japan
7
Division of Cardiology, Ootakanomori Hospital, Kashiwa, Japan
8
Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
Department of Cardiology, Fukuoka Sanno Hospital, Fukuoka, Japan
Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, 1‑847 Amanuma, Omiya, Saitama City 330‑8503, Japan
2
Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan
9
3
Department of Cardiology, Miyazaki Medical Association Hospital, Miyazaki, Japan
10
Department of Cardiovascular Medicine, Chiba Univers
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