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Low burr-to-artery ratio predict stent underexpansion in patients with high OCT based calcium score underwent rotablator atherectomy


 
 
 Stent under-expansion is the potent predictor for stent thrombosis.
 
 
 
 We aim to determine the incidence of stent under-expansion and its predictors in patient who undergoing rotational atherectomy (RA) assisted percutaneous coronary intervention (PCI) assessed by optical coherence tomography (OCT).
 
 
 
 The study included 83 consecutive patients who undergoing OCT guidance RA assisted PCI during January 2016 through September 2020. Baseline clinical characteristics and intracoronary imaging data were recorded. Stent under-expansion was defined as the minimal stent area divided by average of proximal and distal reference lumen area <80%.
 
 
 
 Majority of patients (83%) had OCT based calcium score 3–4. The incidence of stent under-expansion was 9.6%. Comparing between the patient with optimized stent expansion and stent under-expansion, patients with stent under-expansion has older age (79.1±6 vs 69.8±10.4, p=0.015), higher calcium thickness (1.01±0.83 vs 0.65±0.22, p<0.001), longer calcium length (18.68±1.88 vs 12.69±5.33, p<0.001). and lower burr to artery ratio (0.53±0.09 vs 0.65±0.09, p<0.001). The optimal cut-off values of burr to artery ratio <0.54 predict stent under-expansion.
 
 
 
 In the patients with high OCT based calcium score underwent RA assisted PCI, burr to artery ratio<0.54 is a predictor for stent underexpansion.
 
 
 
 Type of funding sources: None.
