Rota-Tripsy or step-up-approach rotational atherectomy for severe coronary artery calcification treatment: a comparative effectiveness study

• Published in: Scientific reports 2024-12, Vol.14 (1), p.29866-8
• Main Authors: Cui, Fengwen, Tong, Yaliang, Yang, Ping, Liu, Guohui, Du, Beibei, Li, Xiangdong, Liu, Kun, Fan, Jiwen, Si, Daoyuan, He, Yuquan
• Format: Article
• Language: English
• Subjects: 692/308/2779; 692/4019; 692/4019/2776; Aged; Atherectomy, Coronary - methods; Calcification; Calcification (ectopic); Comparative studies; Coronary Angiography - methods; Coronary artery; Coronary artery calcification; Coronary Artery Disease - surgery; Coronary Artery Disease - therapy; Coronary heart disease; Coronary Vessels - diagnostic imaging; Coronary Vessels - surgery; Female; Fluoroscopy; Heart rate; Humanities and Social Sciences; Humans; Implants; Intravascular lithotripsy; Intravascular Ultrasound; Lesions; Male; Middle Aged; multidisciplinary; Optical coherence tomography; Patients; Retrospective Studies; Rota-Tripsy; Safety; Science; Science (multidisciplinary); Treatment Outcome; Vascular Calcification - diagnostic imaging; Vascular Calcification - surgery; Vascular Calcification - therapy
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-80769-5

Step-up-approach rotational atherectomy has been widely recognized in the treatment of severe calcified plaques. As an alternative, the rota-tripsy procedure is a novel strategy for the modification of calcification lesions. This study aimed to evaluate and compare the efficacy and safety of rota-tripsy and step-up-approach rotational atherectomy, given the limited clinical data available. Clinical data of 3652 patients with coronary calcification were retrospectively collected from February 2021 to February 2024. The cases were divided into two groups based on the technical approach. The primary efficacy endpoint was procedural success (stent expansion rate > 70% and no hospital major adverse cardiac events [MACEs]). The primary safety endpoint was the absence of serious angiographic complications and 30 days MACEs. A total of 37 patients (38 calcified lesions) screened and included in the study, with 18 cases (19 lesions) in group A and 19 cases in group B. The results showed no significant differences in primary efficacy endpoint. However, group A recorded a lower incidence of angiographic complications ( P  = 0.02) and shorter dose area product and fluoroscopy/interval times compared with group B ( P