Efficacy of a heparin based rota-flush solution in patients undergoing rotational atherectomy

Hoyle L. Whiteside, Supawat Ratanapo, Albert Sey, Abdullah Omar, Deepak Kapoor

Research output: Contribution to journalArticle

Abstract

Introduction: The efficacy of heparin based flush solutions in rotational atherectomy (RA) has not been validated. Recently, a single center study demonstrated the feasibility of an alternative flush solution with 10,000 U of unfractionated heparin (UFH) in 1 L of normal saline. We aimed to evaluate the safety and efficacy of an alternative flush solution intermittently utilized at our institution. Methods: We retrospectively identified 150 patients undergoing RA over a three year period. One hundred cases utilized an alternative flush solution containing 10,000 U UFH, 400mcg nitroglycerin, and 10 mg verapamil in 1 L normal saline and fifty cases utilized RotaGlide Lubricant (Boston Scientific) in addition to heparin and vasodilators in the same dose. The primary end point was to compare rates of procedural success. Secondary endpoints were to report procedural characteristics including the incidence of major adverse cardiac events (MACE) and minor periprocedural complications. Results: Procedural success was achieved in 98% (98/100) of cases utilizing the alternative Rota-Flush solution compared to 100% (50/50) in the Rota-Glide group (P = 0.553). A total of 292 lesions (200 Rota-Flush vs 92 Rota-Glide) were targeted for intervention. MACE occurred in 13 (13%) and 4 (8%) cases in the Rota-Flush and Rota-Glide groups, respectively (P = 0.425). Conclusion: Rotational atherectomy performed with the previously defined Rota-Flush or Rota-Glide solutions resulted in similar rates of procedural success. There were no significant disparities in incidence of MACE and minor periprocedural complications between the two groups. Heparin based rota-flush solutions can be effective alternatives to traditional solutions containing RotaGlide Lubricant.

Original languageEnglish (US)
Pages (from-to)333-337
Number of pages5
JournalCardiovascular Revascularization Medicine
Volume19
Issue number3
DOIs
StatePublished - Apr 1 2018

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Coronary Atherectomy
Heparin
Lubricants
Incidence
Nitroglycerin
Feasibility Studies
Verapamil
Vasodilator Agents
Safety

Keywords

  • Coronary artery disease
  • Percutaneous coronary intervention
  • Rotational atherectomy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Efficacy of a heparin based rota-flush solution in patients undergoing rotational atherectomy. / Whiteside, Hoyle L.; Ratanapo, Supawat; Sey, Albert; Omar, Abdullah; Kapoor, Deepak.

In: Cardiovascular Revascularization Medicine, Vol. 19, No. 3, 01.04.2018, p. 333-337.

Research output: Contribution to journalArticle

Whiteside, Hoyle L. ; Ratanapo, Supawat ; Sey, Albert ; Omar, Abdullah ; Kapoor, Deepak. / Efficacy of a heparin based rota-flush solution in patients undergoing rotational atherectomy. In: Cardiovascular Revascularization Medicine. 2018 ; Vol. 19, No. 3. pp. 333-337.
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abstract = "Introduction: The efficacy of heparin based flush solutions in rotational atherectomy (RA) has not been validated. Recently, a single center study demonstrated the feasibility of an alternative flush solution with 10,000 U of unfractionated heparin (UFH) in 1 L of normal saline. We aimed to evaluate the safety and efficacy of an alternative flush solution intermittently utilized at our institution. Methods: We retrospectively identified 150 patients undergoing RA over a three year period. One hundred cases utilized an alternative flush solution containing 10,000 U UFH, 400mcg nitroglycerin, and 10 mg verapamil in 1 L normal saline and fifty cases utilized RotaGlide Lubricant (Boston Scientific) in addition to heparin and vasodilators in the same dose. The primary end point was to compare rates of procedural success. Secondary endpoints were to report procedural characteristics including the incidence of major adverse cardiac events (MACE) and minor periprocedural complications. Results: Procedural success was achieved in 98{\%} (98/100) of cases utilizing the alternative Rota-Flush solution compared to 100{\%} (50/50) in the Rota-Glide group (P = 0.553). A total of 292 lesions (200 Rota-Flush vs 92 Rota-Glide) were targeted for intervention. MACE occurred in 13 (13{\%}) and 4 (8{\%}) cases in the Rota-Flush and Rota-Glide groups, respectively (P = 0.425). Conclusion: Rotational atherectomy performed with the previously defined Rota-Flush or Rota-Glide solutions resulted in similar rates of procedural success. There were no significant disparities in incidence of MACE and minor periprocedural complications between the two groups. Heparin based rota-flush solutions can be effective alternatives to traditional solutions containing RotaGlide Lubricant.",
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AU - Kapoor, Deepak

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N2 - Introduction: The efficacy of heparin based flush solutions in rotational atherectomy (RA) has not been validated. Recently, a single center study demonstrated the feasibility of an alternative flush solution with 10,000 U of unfractionated heparin (UFH) in 1 L of normal saline. We aimed to evaluate the safety and efficacy of an alternative flush solution intermittently utilized at our institution. Methods: We retrospectively identified 150 patients undergoing RA over a three year period. One hundred cases utilized an alternative flush solution containing 10,000 U UFH, 400mcg nitroglycerin, and 10 mg verapamil in 1 L normal saline and fifty cases utilized RotaGlide Lubricant (Boston Scientific) in addition to heparin and vasodilators in the same dose. The primary end point was to compare rates of procedural success. Secondary endpoints were to report procedural characteristics including the incidence of major adverse cardiac events (MACE) and minor periprocedural complications. Results: Procedural success was achieved in 98% (98/100) of cases utilizing the alternative Rota-Flush solution compared to 100% (50/50) in the Rota-Glide group (P = 0.553). A total of 292 lesions (200 Rota-Flush vs 92 Rota-Glide) were targeted for intervention. MACE occurred in 13 (13%) and 4 (8%) cases in the Rota-Flush and Rota-Glide groups, respectively (P = 0.425). Conclusion: Rotational atherectomy performed with the previously defined Rota-Flush or Rota-Glide solutions resulted in similar rates of procedural success. There were no significant disparities in incidence of MACE and minor periprocedural complications between the two groups. Heparin based rota-flush solutions can be effective alternatives to traditional solutions containing RotaGlide Lubricant.

AB - Introduction: The efficacy of heparin based flush solutions in rotational atherectomy (RA) has not been validated. Recently, a single center study demonstrated the feasibility of an alternative flush solution with 10,000 U of unfractionated heparin (UFH) in 1 L of normal saline. We aimed to evaluate the safety and efficacy of an alternative flush solution intermittently utilized at our institution. Methods: We retrospectively identified 150 patients undergoing RA over a three year period. One hundred cases utilized an alternative flush solution containing 10,000 U UFH, 400mcg nitroglycerin, and 10 mg verapamil in 1 L normal saline and fifty cases utilized RotaGlide Lubricant (Boston Scientific) in addition to heparin and vasodilators in the same dose. The primary end point was to compare rates of procedural success. Secondary endpoints were to report procedural characteristics including the incidence of major adverse cardiac events (MACE) and minor periprocedural complications. Results: Procedural success was achieved in 98% (98/100) of cases utilizing the alternative Rota-Flush solution compared to 100% (50/50) in the Rota-Glide group (P = 0.553). A total of 292 lesions (200 Rota-Flush vs 92 Rota-Glide) were targeted for intervention. MACE occurred in 13 (13%) and 4 (8%) cases in the Rota-Flush and Rota-Glide groups, respectively (P = 0.425). Conclusion: Rotational atherectomy performed with the previously defined Rota-Flush or Rota-Glide solutions resulted in similar rates of procedural success. There were no significant disparities in incidence of MACE and minor periprocedural complications between the two groups. Heparin based rota-flush solutions can be effective alternatives to traditional solutions containing RotaGlide Lubricant.

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KW - Percutaneous coronary intervention

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