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Intravascular ultrasound enhances the safety of rotational atherectomy Effect of orbital atherectomy in calcified coronary artery lesions as assessed by optical coherence tomography Trends in Usage and Clinical Outcomes of Coronary Atherectomy: A Report From the National Cardiovascular Data Registry CathPCI Registry In vivo comparison of lipid-rich plaque on near-infrared spectroscopy with histopathological analysis of coronary atherectomy specimens Two-year outcomes after treatment of severely calcified coronary lesions with the orbital atherectomy system and the impact of stent types: Insight from the ORBIT II trial Chronic Total Occlusion Interventions: Update on Current Tips and Tricks Temporal changes in radial access use, associates and outcomes in patients undergoing PCI using rotational atherectomy between 2007 and 2014: results from the British Cardiovascular Intervention Society national database In-Hospital Outcomes of Chronic Total Occlusion Percutaneous Coronary Interventions in Patients With Prior Coronary Artery Bypass Graft Surgery Rotational Atherectomy in acute STEMI with heavily calcified culprit lesion is a rule breaking solution Procedural Success and Outcomes With Increasing Use of Enabling Strategies for Chronic Total Occlusion Intervention
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Original Research2019 May;12(5):e007448.

JOURNAL：Circ Cardiovasc Interv. Article Link

North American Expert Review of Rotational Atherectomy

Sharma SK, Tomey MI, Teirstein PS et al. Keywords: atherectomy; atherosclerosis; calcium; consensus; percutaneous coronary intervention

ABSTRACT

Rotational atherectomy (RA) is an established tool in interventional cardiology for treatment of calcified coronary lesions. Over 3 decades of clinical experience and research, techniques have matured and outcomes have improved. Heterogeneity exists, however, in RA utilization and technique. We assembled a group of experienced RA operators and device experts to summarize and critique key elements of contemporary RA technique, to identify areas of consensus and controversy, and to offer recommendations for optimal performance for the practicing interventional cardiologist. Evolution in RA strategy toward a focus on lesion modification to facilitate balloon angioplasty and stenting has underpinned major advances in procedural safety, including opportunity to use smaller caliber equipment and radial access. Optimal technique and improved safety have permitted exploratory use of RA for different lesion types and reevaluation of procedural requirements, including flush solution composition and transvenous pacing. Preparedness to manage complications remains paramount and recommendations for operators and institutions are outlined.

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