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"RotaTripsy" as State-of-the-Art Strategy for Coronary Artery Calcification: A Scoping Review
Tianxu Hao1,2,3, Zhenchun Song1, Jiechun Li4
1Clinical School of Thoracic, Tianjin Medical University, Tianjin, China.
Insights
The RotaTripsy procedure, combining rotational atherectomy and intravascular lithotripsy, effectively treats severe calcified coronary lesions. This technique demonstrates feasibility, safety, and positive clinical outcomes for patients with complex coronary artery disease.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Severe coronary calcification poses challenges for percutaneous coronary intervention.
- Rotational atherectomy (RA) and intravascular lithotripsy (IVL) are used to treat complex coronary lesions.
- The combination of RA and IVL, termed 'RotaTripsy,' is emerging for severe calcified lesions.
Purpose of the Study:
- To review current evidence on the RotaTripsy technique for severe calcified coronary lesions.
- To assess the safety, feasibility, and effectiveness of RotaTripsy.
- To emphasize patient and lesion selection for optimal outcomes.
Main Methods:
- Systematic literature search of PubMed, Embase, Web of Science, and Cochrane Library up to July 2024.
- Inclusion of studies combining RA and IVL for coronary artery calcification.
- Scoping review methodology using SPSS and Excel for data analysis.
Main Results:
- 25 studies with 259 patients were analyzed.
- The RotaTripsy procedure had a high success rate of 97.3% (252 patients).
- A low mortality rate of 2.7% (7 patients) was observed during follow-up.
Conclusions:
- RotaTripsy is an effective therapeutic option for severe calcified coronary artery lesions.
- The technique shows unique potential for lesions resistant to conventional dilation.
- Clinical findings support the feasibility, safety, and effectiveness of RotaTripsy.
Abstract:
Background: Recently, the combination of rotational atherectomy (RA) with intravascular lithotripsy (IVL), known as "RotaTripsy," has been employed in the treatment of coronary lesions with severe calcification. In this article, we provide an overview of the current evidence regarding this technique, emphasizing the importance of appropriate patient and lesion selection to achieve optimal clinical outcomes, including the primary goal of improvement of stenting and enhancement of short and long-term prognosis. Methods: We performed a systematic literature search using PubMed, Embase, Web of Science, and Cochrane library up to July 2024 for studies that combined RA and IVL for coronary artery calcification lesions that were included. The retrieved articles and references of the primary articles were used to collect the basic information. SPSS 20.0 and Excel statistic software were used to conduct this scoping review. Results: A total of 25 studies consisting of 259 patients were identified. Of all the patients, 208 (80.3%) were male. Patients had an average age of 68.31 years, and 119 (45.95) patients had acute coronary syndrome. In addition, 218 (84.17%) had hypertension, 128 (49.42%) had diabetes mellitus, and 48 (18.53%) had chronic kidney disease. In the ultimate analysis, 252 patients (97.3%) successfully underwent the "RotaTripsy" procedure, with a minimal mortality rate of only 7 individuals (2.7%) during the follow-up period. Conclusions: "RotaTripsy," as an efficacious therapeutic modality, shows its unique potential for severe calcified coronary artery lesions resistant to dilation. Our research findings substantiate its feasibility, safety, and effectiveness in clinic.
