title: Comparison of Rotational Atherectomy Versus Orbital Atherectomy for the Treatment of Heavily Calcified Coronary Plaques.
abstract: We evaluated the outcomes of patients with severe coronary artery calcification (CAC) who underwent rotational atherectomy (RA) and orbital atherectomy (OA). Severe CAC increases the complexity of percutaneous coronary intervention (PCI) because of the difficulty in optimizing stent expansion, leading to worse clinical outcomes. Both devices are effective treatment strategies for severe CAC. No comparisons have been performed to evaluate the clinical outcomes after RA and OA. The outcomes of 67 patients with severe CAC who underwent RA from July 2012 to June 2015 and 60 patients who underwent OA from February 2014 to September 2016 were evaluated. The primary end point was the rate of 30-day major adverse cardiac and cerebrovascular events, comprising cardiac death, myocardial infarction, target vessel revascularization, and stroke. The primary end point was similar in the RA and OA groups (6% vs 6%, p >0.9), as were the individual end points of death (0% vs 2%, p = 0.8), myocardial infarction (6% vs 4%, p = 0.7), target vessel revascularization (0% vs 0%, p >0.9), and stroke (0% vs 0%, p >9). Procedural success was achieved in all patients. Angiographic complications were uncommon in both groups. No patient had stent thrombosis. In conclusion, both RA and OA are safe and effective for the treatment of severe CAC as they provided similar clinical outcomes at short-term follow-up.
authors.affiliation: Division of Cardiology, UCLA Medical Center, Los Angeles, California. Electronic address: mslee@mednet.ucla.edu.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Kyung Woo
authors.initials: KW
authors.lastname: Park
authors.affiliation: Department of Cardiology, Northwell Health, Manhasset, New York.
authors.forename: Evan
authors.initials: E
authors.lastname: Shlofmitz
authors.affiliation: Cardiology Department, St. Francis Hospital-The Heart Center, Roslyn, New York.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Shlofmitz
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000209:etiology / Q000601:surgery; D017225:Atherectomy, Coronary / Q000379:methods*; D003324:Coronary Artery Disease / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D000072658:Non-ST Elevated Myocardial Infarction / Q000209:etiology / Q000601:surgery; D062645:Percutaneous Coronary Intervention / Q000379:methods; D058226:Plaque, Atherosclerotic / Q000150:complications / Q000601:surgery*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015607:Stents; D020521:Stroke / Q000453:epidemiology; D016896:Treatment Outcome; D061205:Vascular Calcification / Q000150:complications / Q000601:surgery*