The multivariate logistic regression model showed a significant association between slow flow and pre-IVUS uncrossed lesions (vs. The incidence of severe slow flow (TIMI grade ≤ 1) was also greater in the IVUS-uncrossable group than in the IVUS-crossable group (9.7% vs. The incidence of slow flow (TIMI flow grade ≤ 2) was significantly greater in the IVUS-uncrossable group than in the IVUS-crossable group (26.1% vs. The primary endpoint was slow flow just after RA. We included 284 RA lesions, and divided into an IVUS-crossable group (n = 150) and an IVUS-uncrossable group (n = 134). The aim of this study was to compare the incidence of slow flow following RA between IVUS-crossable versus IVUS-uncrossable calcified lesions. The present study provides insights into the selection of an appropriate burr for IVUS-uncrossable lesions.Īlthough the usefulness of intravascular ultrasound (IVUS) in rotational atherectomy (RA) has been widely recognized, an IVUS catheter may not cross the target lesion because of severe calcification. In conclusion, the incidence of complications following RA was comparable between the 1.25-mm and the 1.5-mm burrs as the initial burr for IVUS-uncrossable lesions. The use of the 1.5-mm burr as the initial burr was not significantly associated with slow flow after controlling for chronic renal failure on hemodialysis and reference diameter (vs. The incidence of peri-procedural MI with slow flow was not different and equally low in the 2 groups (1.25-mm group: 1.9%, 1.5-mm group: 3.5%, P =0.61). The incidence of slow flow just after RA was not different between the 2 groups (1.25-mm group: 25%, 1.5-mm group: 31.6%, P =0.45). A total of 109 IVUS-uncrossable lesions were included, and were divided into a 1.25-mm group (n =52) and a 1.5-mm group (n =57). This was a retrospective, single-center study. The aim of this study was to compare the incidence of complications with a 1.25-mm versus a 1.5-mm burr as the initial burr for IVUS-uncrossable lesions. Although small burrs (1.25 mm or 1.5 mm) should be selected for such tight lesions, it is unknown whether a 1.25-mm burr or 1.5-mm burr is safer as the initial burr. However, some calcified lesions do not allow imaging catheters to cross before RA. Since intravascular imaging such as intravascular ultrasound (IVUS) can provide useful information for rotational atherectomy (RA), intravascular imaging should be attempted before RA.
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