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Related Experiment Video

Updated: Oct 14, 2025

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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[Why and how do I use the orbitalatherectomy ?]

Angela Acheampong1, Jacques Monsegu1

  • 1Institut Cardio Vasculaire, GroupeHospitalierMutualiste de Grenoble, 8 rue du DrCalmette 38000Grenoble, France.

Annales De Cardiologie Et D'Angeiologie
|November 7, 2021
PubMed
Summary

Orbital atherectomy (OA) effectively prepares complex calcified coronary lesions for stenting. While safe and effective, it carries risks like dissection and perforation, requiring careful consideration.

Keywords:
AngioplastieAthérectomie orbitaleCalcification coronaireCoronary artery calcificationDiamondback 360™Orbital AtherectomyPercutaneous coronary intervention

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Area of Science:

  • Cardiovascular Interventions
  • Interventional Cardiology
  • Medical Device Technology

Background:

  • Severe coronary artery calcification complicates percutaneous coronary interventions.
  • Atherectomy is a key technique for preparing calcified lesions before stent placement.

Purpose of the Study:

  • To evaluate the safety and efficacy of Orbital atherectomy (OA) for preparing calcified coronary lesions.
  • To compare OA with other atherectomy methods in complex coronary interventions.

Main Methods:

  • Utilized the Orbital atherectomy (OA) Diamondback 360™ system with a specialized Nitinol guidewire (ViperWire™).
  • Employed a diamond-tipped, eccentrically rotating crown to abrade and fracture calcified plaques.
  • ORBIT I and ORBIT II studies provided data on OA's performance.

Main Results:

  • OA demonstrated safety and effectiveness in preparing calcium plaques.
  • Compared to rotational atherectomy, OA showed a lower rate of Major Adverse Cardiovascular Events (MACE) at one year.
  • OA was associated with reduced target vessel revascularization and shorter fluoroscopy times.
  • However, OA use was linked to an increased incidence of coronary dissection and perforation.

Conclusions:

  • Orbital atherectomy is a valuable tool for preparing calcified coronary lesions.
  • It offers an attractive, safe, and effective alternative for complex PCI.
  • Careful patient selection and technique are crucial due to potential complications like dissection and perforation.