One‐year outcomes of patients undergoing percutaneous coronary intervention with the revived directional coronary atherectomy catheter: Insights from the J‐PCI OUTCOME registry

Abstract Objectives We sought to investigate the 1‐year outcomes, including all‐cause and cardiovascular mortality, major adverse cardiovascular events (MACEs), and major bleeding, of patients undergoing percutaneous coronary intervention (PCI) with or without the revived directional coronary atherectomy (DCA) catheter in a Japanese nationwide registry. Background Clinical data regarding the midterm outcomes of patients undergoing PCI with DCA are scarce in contemporary real‐world practice. Methods We analyzed the data of 74,764 patients who underwent PCI at 179 hospitals from January 2017 to December 2018. The baseline characteristics and 1‐year outcomes of patients with stable coronary artery disease or unstable angina who underwent PCI with or without DCA were assessed. Results Overall, 431 patients (0.6%) underwent PCI with DCA. Patients in the DCA group were younger and predominantly male, with fewer comorbidities than patients in the non‐DCA group. Stentless PCI with DCA following additional drug‐coated balloon (DCB) angioplasty was the dominant strategy in the DCA group (43.6%). One‐year outcomes, including all‐cause mortality (1.2% in the DCA group vs. 2.5% in the non‐DCA group, respectively, p = 0.075), cardiovascular death (0.9% vs. 1.0%, p = 0.69), MACEs (1.9% vs. 1.8%, p = 0.96), and nonfatal major bleeding requiring readmission (1.2% vs. 1.4%, p = 0.62), were comparable between the two groups. In the DCA group, 1‐year outcomes were comparable, regardless of whether the stent or DCB was used. Conclusions One‐year clinical outcomes after PCI with DCA in patients with stable coronary artery disease or unstable angina are acceptable, regardless of stent use.