Comparison of interventional treatment options for coronary calcified nodules: A sub-analysis of the ROTA.shock trial
Blachutzik F, Meier S, Blachutzik 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, Hamm C, Nef H (2024)
Publication Language: English
Publication Type: Journal article
Publication year: 2024
Journal
DOI: 10.1016/j.carrev.2024.05.030
Abstract
Background: The optimal treatment for coronary calcified nodules (CNs) is still unclear. The aim of this study was to compare the modification of these lesions by coronary intravascular lithotripsy (IVL) and rotational atherectomy (RA) using optical coherence tomography (OCT). Methods: ROTA.shock was a 1:1 randomized, prospective, double-arm multi-center non-inferiority trial that compared the use of IVL and RA with percutaneous coronary intervention (PCI) in severely calcified lesions. In 19 of the patients out of this study CNs were detected by OCT in the target lesion and were treated by either IVL or RA. Results: The mean angle of CNs was significantly larger in final OCT scans than before RA (92 ± 17° vs. 68 ± 7°; p = 0.01) and IVL (89 ± 18° vs. 60 ± 10°; p = 0.03). The CNs were thinner upon final scans than in initial native scans (RA: 17.8 ± 7.8 mm vs. 38.6 ± 13.1 mm; p = 0.02; IVL: 16.5 ± 9.0 mm vs. 37.2 ± 14.3 mm; p = 0.02). Nodule volume did not differ significantly between native and final OCT scans (RA: 0.66 ± 0.12 mm3 vs. 0.61 ± 0.33 mm3; p = 0.68; IVL: 0.64 ± 0.19 mm3 vs. 0.68 ± 0.22 mm3; p = 0.74). Final stent eccentricity was high with 0.62 ± 0.10 after RA and 0.61 ± 0.09 after IVL. Conclusion: RA or IVL are unable to reduce the volume of the calcified plaque. CN modulation seems to be mainly induced by the stent implantation and not by RA or IVL.
Authors with CRIS profile
Luise Gaede
Department of Medicine 2 – Cardiology and Angiology
Stephan Achenbach
Lehrstuhl für Innere Medizin II
Involved external institutions
Kerckhoff-Klinik
Germany (DE)
St.-Johannes-Hospital
Germany (DE)
Universitätsklinikum Bonn
Germany (DE)
Justus-Liebig-Universität Gießen
Germany (DE)
Universitätsmedizin der Johannes Gutenberg-Universität Mainz
Germany (DE)
Germany (DE)
St.-Johannes-Hospital
Germany (DE)
Universitätsklinikum Bonn
Germany (DE)
Justus-Liebig-Universität Gießen
Germany (DE)
Universitätsmedizin der Johannes Gutenberg-Universität Mainz
Germany (DE)
How to cite
APA:
Blachutzik, F., Meier, S., Blachutzik, M., Schlattner, S., Gori, T., Ullrich-Daub, H.,... Nef, H. (2024). Comparison of interventional treatment options for coronary calcified nodules: A sub-analysis of the ROTA.shock trial. Cardiovascular Revascularization Medicine. https://doi.org/10.1016/j.carrev.2024.05.030
MLA:
Blachutzik, Florian, et al. "Comparison of interventional treatment options for coronary calcified nodules: A sub-analysis of the ROTA.shock trial." Cardiovascular Revascularization Medicine (2024).
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