1. Rotational atherectomy of calcified coronary lesions: current practice and insights from two randomized trials.
- Author
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Allali A, Abdel-Wahab M, Elbasha K, Mankerious N, Traboulsi H, Kastrati A, El-Mawardy M, Hemetsberger R, Sulimov DS, Neumann FJ, Toelg R, and Richardt G
- Subjects
- Humans, Coronary Angiography methods, Treatment Outcome, Randomized Controlled Trials as Topic, Retrospective Studies, Atherectomy, Coronary methods, Coronary Artery Disease diagnosis, Coronary Artery Disease surgery, Vascular Calcification diagnosis, Vascular Calcification surgery, Drug-Eluting Stents
- Abstract
With growing experience, technical improvements and use of newer generation drug-eluting stents (DES), recent data showed satisfactory acute and long-term results after rotational atherectomy (RA) in calcified coronary lesions. The randomized ROTAXUS and PREPARE-CALC trials compared RA to balloon-based strategies in two different time periods in the DES era. In this manuscript, we assessed the technical evolution in RA practice from a pooled analysis of the RA groups of both trials and established a link to further recent literature. Furthermore, we sought to summarize and analyze the available experience with RA in different patient and lesion subsets, and propose recommendations to improve RA practice. We also illustrated the combination of RA with other methods of lesion preparation. Finally, based on the available evidence, we propose a simple and practical approach to treat severely calcified lesions., (© 2022. The Author(s).)
- Published
- 2023
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