"RotaTripsy": Combination of Rotational Atherectomy and Intravascular Lithotripsy in Heavily Calcified Coronary...

Area of Science:

• Interventional Cardiology
• Cardiovascular Devices
• Medical Technology

Background:

• Heavily calcified coronary lesions pose significant challenges during percutaneous coronary interventions (PCI), often leading to stent underexpansion and adverse clinical outcomes.
• While rotational atherectomy is a primary treatment for severe calcification, it may be insufficient for deeply circumferential plaques, limiting optimal device expansion.

Purpose of the Study:

• To evaluate the efficacy and feasibility of a novel combined approach, termed "RotaTripsy," for treating complex calcified coronary lesions.
• To assess the "RotaTripsy" technique's ability to facilitate optimal stent implantation in cases where rotational atherectomy alone is inadequate.

Main Methods:

• A case series describing the utilization of rotational atherectomy followed by intracoronary lithotripsy for percutaneous coronary intervention (PCI).
• The "RotaTripsy" technique was employed to modify severely calcified plaques, aiming to improve deliverability and expansion of subsequent stent devices.

Main Results:

• The "RotaTripsy" technique demonstrated effectiveness in modifying calcified plaques, enabling successful stent implantation in challenging lesions.
• This combined approach addresses limitations of rotational atherectomy alone, particularly in cases with circumferential deep calcium.

Conclusions:

• The complementary use of intracoronary lithotripsy with rotational atherectomy ("RotaTripsy") is a promising strategy for managing complex calcified coronary lesions.
• This technique offers an effective solution for achieving adequate stent expansion and potentially improving clinical outcomes in patients undergoing PCI for heavily calcified arteries.