Iranian Heart Journal

Iranian Heart Journal

Rotablator Utilization in Managing Complex Calcified Coronary Lesions: A Study of Immediate and Follow-Up Outcomes From an Indian Medical Center

Document Type : Original Article

Authors
Mohammad Maqbool Sohil 1
Hakim Irfan Showkat 2
Sadaf Anwar 2
1 Narayana Hrudayalaya Institute, Ahmedabad India.
2 Srinagar MedCity Heart Institute, Kashmir, India.
Abstract
Background: Rotational atherectomy is an established tool in interventional cardiology for the treatment of calcified coronary lesions. The treatment of calcified lesions (in contrast to simple lesions) with percutaneous transluminal coronary angioplasty has been linked to increased procedural difficulties and a lower success rate. Although rotablation can enhance acute outcomes, the significant restenosis rate still poses a challenge.
 
Methods: This study aimed to assess the clinical and angiographic results of patients treated with a combination of stenting and rotablation for complicated and calcified lesions.
 
Results: Before coronary stenting, rotablation was consecutively performed on 106 patients. In 67% of the patients, intravascular ultrasound-guided stenting was employed. The success rate for angiography was 100%, and 96.2% of lesions had successful procedures. Two lesions (1.8%) experienced acute stent thrombosis, while 1 lesion (0.9%) experienced subacute stent thrombosis. Every patient had clinical follow-up at 1 month, 3 months, and 6.4 ± 3 months. Revascularization of the target lesion was required in 1.8% of lesions, Q-wave myocardial infarction occurred in 0.9% of lesions, and mortality was 0.9%.
 
Conclusions: In the present era, optimal coronary stenting after rotablation in calcified and complex lesions can be performed with a high success rate, an acceptable rate of procedural complications, and a low rate of stent thrombosis. This approach is associated with a low incidence of angiographic restenosis compared with results typically obtained with other interventional strategies in calcified and complex lesion subsets. (Iranian Heart Journal 2025; 26(1): 16-26)
Keywords
Rotablation
Calcified lesion
NSTEMI
Left main
Bifurcation
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Iranian Heart Journal
Volume 26, Issue 1
Winter 2025
Pages 16-26