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Rota-Tripsy or step-up-approach rotational atherectomy for severe coronary artery calcification treatment: a
Fengwen Cui1, Yaliang Tong1, Ping Yang1
1Department of Cardiovascular Medicine, China-Japan Union Hospital of Jilin University, No.126 Xiantai street of Changchun city, Changchun, 130033, China.
Insights
Rota-tripsy and step-up rotational atherectomy both effectively treat severe coronary calcification. Rota-tripsy demonstrated improved safety with fewer complications and greater efficiency.
Area of Science:
- Cardiovascular Interventions
- Interventional Cardiology
- Medical Device Technology
Background:
- Severe coronary calcification poses challenges for percutaneous coronary intervention.
- Step-up-approach rotational atherectomy is a recognized treatment for calcified plaques.
- Rota-tripsy is a novel strategy for coronary calcification modification.
Purpose of the Study:
- To compare the efficacy and safety of rota-tripsy versus step-up-approach rotational atherectomy.
- To evaluate clinical outcomes in patients with severe coronary calcification.
Main Methods:
- Retrospective analysis of 3652 patients with coronary calcification (Feb 2021-Feb 2024).
- 37 patients (38 lesions) were divided into two groups: rota-tripsy (Group A) and step-up-approach rotational atherectomy (Group B).
- Primary endpoints: procedural success (stent expansion >70%, no hospital MACEs) and safety (no serious angiographic complications, 30-day MACEs).
Main Results:
- No significant difference in primary efficacy endpoints between the two groups.
- Group A (rota-tripsy) showed a lower incidence of angiographic complications (P=0.02).
- Group A demonstrated shorter dose area product and fluoroscopy/interval times compared to Group B (P<0.01).
Conclusions:
- Both rota-tripsy and step-up-approach rotational atherectomy yield favorable short-term clinical results for severe coronary calcification.
- Rota-tripsy offers improved safety and efficiency in managing coronary calcification.
- Further research may elucidate long-term outcomes and optimal patient selection.
Abstract:
Step-up-approach rotational atherectomy has been widely recognized in the treatment of severe calcified plaques. As an alternative, the rota-tripsy procedure is a novel strategy for the modification of calcification lesions. This study aimed to evaluate and compare the efficacy and safety of rota-tripsy and step-up-approach rotational atherectomy, given the limited clinical data available. Clinical data of 3652 patients with coronary calcification were retrospectively collected from February 2021 to February 2024. The cases were divided into two groups based on the technical approach. The primary efficacy endpoint was procedural success (stent expansion rate > 70% and no hospital major adverse cardiac events [MACEs]). The primary safety endpoint was the absence of serious angiographic complications and 30 days MACEs. A total of 37 patients (38 calcified lesions) screened and included in the study, with 18 cases (19 lesions) in group A and 19 cases in group B. The results showed no significant differences in primary efficacy endpoint. However, group A recorded a lower incidence of angiographic complications (P = 0.02) and shorter dose area product and fluoroscopy/interval times compared with group B (P < 0.01). For management of severe coronary calcification, both rota-tripsy and step-up-approach rotational atherectomy had favorable short-term clinical results; however, rota-tripsy provided improved safety and efficiency.
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