MedPath

Rota China Registry

Completed
Conditions
Coronary Artery Disease
Interventions
Procedure: Rotational Atherectomy
Registration Number
NCT03806621
Lead Sponsor
Beijing Anzhen Hospital
Brief Summary

Rotational atherectomy (RA) facilitates percutaneous coronary intervention for complex de novo lesions with severe calcification. Some observational studies and a small randomized trial indicated that a strategy of routine RA did not conferred reduction in restenosis or MACE, but these studies are limited by missing follow-up, insufficient power to compare outcomes, and confounding factors in the RA group (long lesion length, etc.). With recent developments in medical therapy, advances in design and delivery of drug-eluting stents (DES), and advances in noninvasive and intravascular coronary imaging, the use of RA in current real-world practice remains to be well determined. We aimed to compile real-world clinical outcomes data for the RotablatorTM Rotational Atherectomy System in routine clinical practice in China.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
980
Inclusion Criteria
  • Age ≥18 years old

  • Subject who is clinically indicated for PCI/stenting

  • Written informed consent

  • Subject is willing to comply with all protocol-required follow-up evaluation

  • Subject must meet one of following angiographic/procedural inclusion criteria:

    • Target lesion is moderately to severely calcified by visual estimate
    • Unsuccessful balloon dilatation of the target lesion
    • Unsuccessful passage of device(s) (microcatheter, balloon, or stent) across the target lesion
Exclusion Criteria
  • Subject has clinical symptoms and/or electrocardiogram (ECG) changes consistent with acute MI within 2 weeks

  • Subject has any of the following angiographic findings:

    • Thrombus present in the target vessel (by visual estimate)
    • Significant dissection present in the target vessel (NHLBI types C-F)
    • Lesion angulation > 60°(by visual estimate)

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Rotational AtherectomyRotational Atherectomy-
Primary Outcome Measures
NameTimeMethod
Major adverse cardiovascular event (MACE) (primary safety endpoint)30 days

The composite of any ischemia-driven target lesion revascularization (TLR), myocardial infarction (MI), or cardiac death. Periprocedural myocardial infarction, defined as in patients with normal baseline CK-MB, the peak CK-MB measured within 48 hours of the procedure rises to ≥ 10 x the local laboratory ULN, or to ≥ 5 x ULN with new pathologic Q-waves in ≥ 2 contiguous leads or new persistent LBBB (according to SCAI definition. J Am Coll Cardiol 2013;62:1563-70)

Procedural success rate (primary efficacy endpoint)Peri-procedural

A mean lesion diameter stenosis \<30% in 2 near-orthogonal projections with TIMI 3 flow, as visually assessed by the physician, without the occurrence of in-hospital MI, target vessel revascularization (TVR), or cardiac death

Secondary Outcome Measures
NameTimeMethod
Target lesion failure (TLF) rateAt 30 days and 12 months post-index procedure
TLR rateAt 30 days and 12 months post-index procedure
Target vessel failure (TVF) rateAt 30 days and 12 months post-index procedure
TVR rateAt 30 days and 12 months post-index procedure
Cardiac death rateAt 30 days and 12 months post-index procedure
All-cause death rateAt 30 days and 12 months post-index procedure
All-cause death or MI rateAt 30 days and 12 months post-index procedure
All-cause death, MI, or TVR rateAt 30 days and 12 months post-index procedure
Stent thrombosis (ST) rateAt 30 days and 12 months post-index procedure
MI rateAt 30 days and 12 months post-index procedure
Cardiac death or MI rateAt 30 days and 12 months post-index procedure
Subgroup analyses of MACEAt 30 days and 12 months post-index procedure

1. Age (\< 65 years vs. ≥ 65 years), 2. Female, 3. Hypertension, 4. Diabetes, 5. CKD, 6. Left ventricular ejection fraction (≤ 50% vs. \> 50%), 7. LM lesion, 8. Long lesion, 9. CTO, 10. Bifurcation lesion, 11. Speed of rotation, 12. Maximal burr size, 13. IVUS or OCT use

Non-cardiac death rateAt 30 days and 12 months post-index procedure

Trial Locations

Locations (19)

The First Affiliated Hospital of USTC

🇨🇳

Hefei, Anhui, China

Beijing Anzhen Hospital, Capital Medical University

🇨🇳

Beijing, Beijing, China

Beijing Hospital

🇨🇳

Beijing, Beijing, China

Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College

🇨🇳

Beijing, Beijing, China

Peking Union Medical College Hospital

🇨🇳

Beijing, Beijing, China

Guangdong Provincial People's Hospital, Guangdong Academy of Medical Science

🇨🇳

Guangzhou, Guangdong, China

The First Affiliated Hospital, Sun Yat-sen University

🇨🇳

Guangzhou, Guangdong, China

First Hospital of China Medical University

🇨🇳

Shenyang, Liaoning, China

Nanjing First hospital, Nanjing Medical University

🇨🇳

Nanjing, Jiangsu, China

Qilu Hospital (Qingdao), Shandong University

🇨🇳

Jinan, Shandong, China

The First Affiliated Hospital of Xi'an Jiaotong University

🇨🇳

Xi'an, Shaanxi, China

West China Hospital, Sichuan University

🇨🇳

Chengdu, Sichuan, China

Tianjin Fourth Central Hospital

🇨🇳

Tianjin, Tianjin, China

The First People's Hospital of Yunnan Province

🇨🇳

Kunming, Yunnan, China

Sir Run Run Shaw Hospital, Zhejiang University School of Medicine

🇨🇳

Hangzhou, Zhejiang, China

Fuwai Central China Cardiovascular Hospital

🇨🇳

Zhengzhou, Henan, China

The First Affiliated Hospital of Zhengzhou University

🇨🇳

Zhengzhou, Henan, China

Union Hospital, Tongji Medical College, Huazhong University of Science and Technology

🇨🇳

Wuhan, Hubei, China

Xijing Hospital, the Fourth Military Medical University

🇨🇳

Xi'an, Shaanxi, China

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