Comparison of Bailout and Planned Rotational Atherectomy for Heavily Calcified Coronary Lesions: A Single‐Center Experience

Abstract

Shortened procedural duration and reduction of coronary dissections were observed with planned RA for selected lesions. However, this strategy does not affect long-term clinical outcomes.

Editorial: The Conundrum of Calcified Coronaries

“…In contrast, many other studies have found a lower PCI success rate with calcified lesions, resulting in the development of rotational and orbital atherectomy to ablate calcified plaque to facilitate passing devices and dilating the lesion. In this issue of the Journal, a single center study of 559 heavily calcified lesions found that routine rotational atherectomy (RA) was superior to bailout RA with regard to less contrast, fluoroscopy time, fewer dissections, higher angiographic success and reduced in‐hospital MACE . This study is in agreement with the ROTAXUS trial, that showed predictors of crossover to RA included heavy calcification, tight diameter stenosis and type C lesions .…”

“…These four new studies published in the Journal suggest combined therapy with atherectomy and DES or DCB is safe and effective in the management of calcified lesions.…”

Feasibility and clinical outcome of rotational atherectomy in patients presenting with an acute coronary syndrome

“…Technical details of RA at our institution have been previously reported and are in line with the European consensus document . In brief, all procedures were performed using the CE‐marked Rotablator device (Boston Scientific Scimed Inc., Maple Grove, MN).…”

Percutaneous coronary intervention: 2017 in review

“…Although the primary outcomes were similar after propensity matched analysis, these results are in contrast with the previous belief that lesions responsible for ACS are soft, ulcerated, and non-calcified while calcified lesions are more chronic 37. A single center study of 559 patients with heavily calcified lesions found that routine, elective rotational atherectomy (RA) prior to device deployment was superior to bailout RA where RA was employed only after failure of balloon dilatation or stent delivery 38. Planned RA resulted in less contrast use, fluoroscopy time, fewer dissections,…”

“…A single center study of 559 patients with heavily calcified lesions found that routine, elective rotational atherectomy (RA) prior to device deployment was superior to bailout RA where RA was employed only after failure of balloon dilatation or stent delivery . Planned RA resulted in less contrast use, fluoroscopy time, fewer dissections, higher angiographic success, and reduced in‐hospital MACE.…”