Rotational Atherectomy: A Contemporary Appraisal.
Tanush Gupta1,2, Michael Weinreich1, Mark Greenberg1
1Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine Bronx, NY, US.
Interventional Cardiology (London, England)
|December 24, 2019
Summary
Rotational atherectomy (RA) modifies complex, calcified coronary lesions by selectively ablating plaque. Evolving best practices enhance procedural safety and reduce complications for percutaneous coronary intervention.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Rotational atherectomy (RA) is an atheroablative technique for treating complex, calcified coronary lesions.
- It operates on the principle of differential cutting, targeting inelastic calcified plaque.
Purpose of the Study:
- To review the principles, clinical indications, and evidence for rotational atherectomy.
- To discuss technical considerations and complications associated with RA.
Main Methods:
- Review of clinical experience and best practices developed over 30 years.
- Analysis of technique modifications including smaller burr sizes, short ablation runs, and 'pecking' motion.
Main Results:
- RA's objective has shifted from plaque debulking to plaque modification for improved angioplasty and stent expansion.
- Contemporary best practices have significantly improved procedural safety and reduced complication rates.
Conclusions:
- Rotational atherectomy is a valuable tool for complex calcified coronary lesions.
- Evolving techniques and adherence to best practices are crucial for safe and effective RA procedures.
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