ArticleClinical research in cardiology : official journal of the German Cardiac Society2023
Planned versus unplanned rotational atherectomy for plaque modification in severely calcified coronary lesions.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 6 citations in OpenAlex.
- Clinical expert consensus document on rotational atherectomy from the Japanese association of cardiovascular intervention and therapeutics: update 2026.Cardiovascular intervention and therapeutics · 2026Review
- In-hospital outcomes of intravascular lithotripsy compared to rotational atherectomy and cutting/scoring balloon angioplasty.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Procedural safety of rotational atherectomy and modified balloon angioplasty: insights from a German national registry.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Clinical impact of direct rotational atherectomy in patients with complex coronary artery lesions.Scientific reports · 2025Article
- The application of rotational atherectomy in PCI for patients with complex coronary artery calcified lesions.American journal of translational research · 2025Article
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEvidence on the optimal timing of RA is scarce, although increased periprocedural complications for unplanned procedures have been reported.
aimsTo compare planned versus unplanned use of rotational atherectomy (RA) for plaque modification in patients with severely calcified coronary lesions.
methodsProcedural and 1-year follow-up data of planned (n = 562 lesions in 448 vessels of 416 patients) and unplanned (n = 490 lesions in 435 vessels of 403 patients) RA between 2008 and 2020 were analyzed using the propensity score methods. The primary composite endpoint was target lesion failure (TLF), defined as cardiovascular death (CVD), target vessel myocardial infarction (TVMI), or target lesion revascularization (TLR).
resultsAngiographic success was > 99% in both groups. Fluoroscopy time and contrast volume were significantly lower in planned RA (p < 0.001). Periprocedural complications including slow-flow, coronary dissection, and MI occurred in 4.8% after planned, and in 5.7% after unplanned RA. TLF occurred in 18.5% after planned, and in 14.7% after unplanned RA. Weighted subdistribution hazard ratios for TLFs revealed an unfavorable 1-year outcome for planned RA (sHR 1.62 [1.07-2.45], p = 0.023), which was driven by TLR (sHR 2.01 [1.18-3.46], p = 0.011), but not by CVD, or TVMI. No differences were observed in all-cause mortality.
conclusionsUnplanned RA was associated with favorable outcome when compared to planned RA. Thus, RA can safely be reserved for lesions that prove untreatable by conventional means. Randomized and prospective trials are needed to evaluate a predominant use of rotational atherectomy as a bailout strategy in the future.
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