Efficacy and safety of rotational atherectomy versus intravascular lithotripsy in severe coronary artery calcification
YU Yue
WU Zhi-kang
CHEN Jian-zhou
WU Han
WEI Zhong-hai
WANG Kun
KANG Li-na
WANG Lian
Abstract：Objective To compare the efficacy and safety of rotational atherectomy(RA)and intravascular lithotripsy(IVL)in patients with severe coronary artery calcification(CAC).Methods This retrospective cohort study enrolled 155 patients with severe CAC undergoing percutaneous coronary intervention(PCI)with either RA(n=90)or IVL(n=65).Data on baseline characteristics,procedural features,major adverse cardiovascular events(MACE)at 30 days and 6 months and microcirculatory function were collected.Results There was no significant difference between the two groups in surgical success rate(87.8%vs.92.3%,P=0.360).However,the RA group had a higher incidence of periprocedural myocardial injury(28.9%vs.18.5%),although this difference did not reach statistical significance(P=0.056).Higher post-PCI QFRi(QFR of the stent plus 5 mm proximally and distally(in-segment),AMR and the incidence of postoperative microcirculation dysfunction in the RA group was significantly higher in the IVL group[(0.960±0.017)vs.(0.937±0.022),(237.620±35.272)mmHg·s/m vs.(225.510±35.124)mmHg·s/m,40.0%vs.24.6%,all P<0.05].The incidence of MACE at 30 days and 6 months did not differ significantly between the group(3.3%vs.3.1%;5.6%vs.4.6%,all P=1.000).Conclusion RA provides higher post-PCI QFRi,the rate of microvascular dysfunction is lower in IVL group,the safety is similar.
Keywords：Coronary artery calcificationRotational atherectomyIntravascular lithotripsyCoronary microvascular dysfunction
Publication Date：2026-02-25
Online Publishing Date：2026-03-16(First online date of this platform, not the publication date of the document)
Pages：6( 109-114 )