Impact of Burr Speed and Polishing Run Sequences on Rotational Atherectomy Efficacy In Vitro.

Background: The impact of burr speed on rotational atherectomy (RA) mechanical efficacy remains debated. We aimed to analyze the effect of different RA protocols on postinterventional luminal gain. Methods: Procedures were performed in vitro on proximal left anterior descending artery with a 1.75-mm burr in a 3-dimensional-printed beating heart model. All lesions first underwent a high speed (HS; 180,000 revolutions per minute) pecking run followed by a HS polishing run of 30 seconds. This standard technique was completed by additional 30-second low speed (LS; 110,000 revolutions per minute) runs as follows: 1 (LS short group, n = 28 lesions); 2 (LS midgroup, n = 30 lesions), or 3 additional LS runs (LS long group, n = 27 lesions), while the control group (n = 27 lesions) received no additional polishing. An additional HS long group in which 3 additional 30-second HS polishing runs were delivered following the initial standard steps was also created (n = 27 lesions). The specimens were analyzed by microcomputed tomography scan to measure the average luminal volume (ALV) and minimal cross-section area. Results: The baseline lesion ALV and minimal cross -section area were and 128.57 mm Conclusions: These data suggest that additional polishing runs after standard RA procedure improves the debulked lesion volume, regardless of burr speed.