Orbital atherectomy versus rotational atherectomy: A systematic review and meta-analysis

• Published in: International journal of cardiology 2020-03, Vol.303, p.16-21
• Main Authors: Goel, Sunny, Pasam, Ravi Teja, Chava, Srilekha, Gotesman, Joseph, Sharma, Abhishek, Malik, Bilal Ahmad, Frankel, Robert, Shani, Jacob, Gidwani, Umesh, Latib, Azeem
• Format: Article
• Language: English
• Subjects: Atherectomy, Coronary - methods; Calcified coronary artery disease; Coronary Artery Disease - etiology; Coronary Artery Disease - surgery; Coronary Vessels - surgery; Humans; Orbital atherectomy; Percutaneous coronary intervention; Risk Factors; Rotational atherectomy; Vascular Calcification - complications; Vascular Calcification - surgery
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2019.12.037

Coronary artery calcification is associated with poor outcomes in patients undergoing percutaneous coronary intervention (PCI). Atheroablative techniques such as orbital atherectomy (OA) and rotational atherectomy (RA) are routinely utilized to treat these calcified lesions in order to optimize lesion preparation and facilitate stent delivery. The purpose of this systematic review and meta-analysis is to compare the performance of OA versus RA in patients with calcified coronary artery disease (CAD) undergoing PCI. We conducted an electronic database search of all published data for studies that compared OA versus RA in patients with calcified coronary artery disease undergoing PCI and reported on outcomes of interest. Event rates were compared using a forest plot of odds ratios using a random-effects model assuming interstudy heterogeneity. A total of five observational studies (total number of patients = 1872; OA = 535, RA = 1337) were included in the final analysis. On pooled analysis, OA compared to RA was associated with a significant reduction in fluoroscopy times (OR = −6.33; 95% CI = −9.90 to −2.76; p