Comparison of Coronary Intravascular Lithotripsy and Rotational Atherectomy in the Modification of Severely Calcified Stenoses
Blachutzik F, Meier S, Weissner M, Schlattner S, Gori T, Ullrich-Daub H, Gaede L, Achenbach S, Möllmann H, Chitic B, Aksoy A, Nickenig G, Weferling M, Dörr O, Boeder N, Bayer M, Elsässer A, Hamm C, Nef H (2023)
Publication Type: Journal article
Publication year: 2023
Journal
DOI: 10.1016/j.amjcard.2023.02.028
Abstract
Debulking techniques are often necessary for successful lesion preparation in percutaneous coronary intervention. The aim of this study was to compare plaque modification of severely calcified lesions by coronary intravascular lithotripsy (IVL) with that of rotational atherectomy (RA) using optical coherence tomography (OCT). ROTA.shock was a 1:1 randomized, prospective, double-arm, multicenter noninferiority trial designed to compare final minimal stent area after IVL with RA for lesion preparation in percutaneous coronary interventional treatment of severely calcified lesions. On the basis of OCT acquired before and immediately after IVL or RA in 21 of the 70 patients included, we performed a detailed analysis of the modification of the calcified plaque. After RA and IVL, calcified plaque fractures were present in 14 of the patients (67%), with a significantly greater number of fractures after IVL (3.23 ± 0.49) than after RA (1.67 ± 0.52; p < 0.001). Plaque fractures after IVL were longer than after RA (IVL: 1.67 ± 0.43 mm vs RA: 0.57 ± 0.55 mm; p = 0.01), resulting in a greater total volume of the fractures (IVL: 1.47 ± 0.40 mm3 vs RA: 0.48 ± 0.27 mm3; p = 0.003). Use of RA was associated with a greater acute lumen gain than was use of IVL (RA: 0.46 ± 0.16 mm2 vs IVL: 0.17 ± 0.14 mm2; p = 0.03). In conclusion, we were able to show differences in plaque modification of calcified coronary lesions by OCT: although RA leads to a greater acute lumen gain, IVL induces more and longer fractures of the calcified plaque.
Authors with CRIS profile
Luise Gaede
Department of Medicine 2 – Cardiology and Angiology
Stephan Achenbach
Lehrstuhl für Innere Medizin II
Involved external institutions
Justus-Liebig-Universität Gießen
Germany (DE)
Kerckhoff-Klinik
Germany (DE)
Universitätsmedizin der Johannes Gutenberg-Universität Mainz
Germany (DE)
St.-Johannes-Hospital
Germany (DE)
Universitätsklinikum Bonn
Germany (DE)
Carl von Ossietzky Universität Oldenburg
Germany (DE)
Germany (DE)
Kerckhoff-Klinik
Germany (DE)
Universitätsmedizin der Johannes Gutenberg-Universität Mainz
Germany (DE)
St.-Johannes-Hospital
Germany (DE)
Universitätsklinikum Bonn
Germany (DE)
Carl von Ossietzky Universität Oldenburg
Germany (DE)
How to cite
APA:
Blachutzik, F., Meier, S., Weissner, M., Schlattner, S., Gori, T., Ullrich-Daub, H.,... Nef, H. (2023). Comparison of Coronary Intravascular Lithotripsy and Rotational Atherectomy in the Modification of Severely Calcified Stenoses. American Journal of Cardiology. https://dx.doi.org/10.1016/j.amjcard.2023.02.028
MLA:
Blachutzik, Florian, et al. "Comparison of Coronary Intravascular Lithotripsy and Rotational Atherectomy in the Modification of Severely Calcified Stenoses." American Journal of Cardiology (2023).
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