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Comparison of Coronary Intravascular Lithotripsy and Rotational Atherectomy in the Modification of Severely Calcified Stenoses.
Blachutzik, Florian; Meier, Sophie; Weissner, Melissa; Schlattner, Sophia; Gori, Tommaso; Ullrich-Daub, Helen; Gaede, Luise; Achenbach, Stephan; Möllmann, Helge; Chitic, Bogdan; Aksoy, Adem; Nickenig, Georg; Weferling, Maren; Dörr, Oliver; Boeder, Niklas; Bayer, Matthias; Elsässer, Albrecht; Hamm, Christian; Nef, Holger.
Affiliation
  • Blachutzik F; Department of Cardiology, Justus Liebig University Giessen, Giessen, Germany. Electronic address: florian.blachutzik@innere.med.uni-giessen.de.
  • Meier S; Department of Cardiology, Justus Liebig University Giessen, Giessen, Germany.
  • Weissner M; Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany.
  • Schlattner S; Department of Cardiology, Justus Liebig University Giessen, Giessen, Germany.
  • Gori T; University Medical Center Mainz, Cardiology I, Mainz, Germany; German Center for Cardiovascular Research, Rhine-Main Partner Site, Mainz, Germany.
  • Ullrich-Daub H; University Medical Center Mainz, Cardiology I, Mainz, Germany.
  • Gaede L; Department of Cardiology, Friedrich-Alexander-University Erlangen, Erlangen, Germany.
  • Achenbach S; Department of Cardiology, Friedrich-Alexander-University Erlangen, Erlangen, Germany.
  • Möllmann H; Department of Cardiology, St. Johannes Hospital, Dortmund, Germany.
  • Chitic B; Department of Cardiology, St. Johannes Hospital, Dortmund, Germany.
  • Aksoy A; Department of Internal Medicine 2, University Hopsital Bonn, Bonn, Germany.
  • Nickenig G; Department of Internal Medicine 2, University Hopsital Bonn, Bonn, Germany.
  • Weferling M; Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany.
  • Dörr O; Department of Cardiology, Justus Liebig University Giessen, Giessen, Germany; German Center for Cardiovascular Research, Rhine-Main Partner Site, Mainz, Germany.
  • Boeder N; Department of Cardiology, Justus Liebig University Giessen, Giessen, Germany.
  • Bayer M; Department of Cardiology, Justus Liebig University Giessen, Giessen, Germany.
  • Elsässer A; Department of Cardiology, University of Oldenburg, Oldenburg, Germany.
  • Hamm C; Department of Cardiology, Justus Liebig University Giessen, Giessen, Germany; Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany; German Center for Cardiovascular Research, Rhine-Main Partner Site, Mainz, Germany.
  • Nef H; Department of Cardiology, Justus Liebig University Giessen, Giessen, Germany; German Center for Cardiovascular Research, Rhine-Main Partner Site, Mainz, Germany.
Am J Cardiol ; 197: 93-100, 2023 06 15.
Article in En | MEDLINE | ID: mdl-37012181
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 11 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.
Subject(s)

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Coronary Artery Disease / Lithotripsy / Angioplasty, Balloon, Coronary / Atherectomy, Coronary / Plaque, Atherosclerotic / Vascular Calcification Type of study: Clinical_trials / Diagnostic_studies / Observational_studies / Risk_factors_studies Limits: Humans Language: En Journal: Am J Cardiol Year: 2023 Document type: Article

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Coronary Artery Disease / Lithotripsy / Angioplasty, Balloon, Coronary / Atherectomy, Coronary / Plaque, Atherosclerotic / Vascular Calcification Type of study: Clinical_trials / Diagnostic_studies / Observational_studies / Risk_factors_studies Limits: Humans Language: En Journal: Am J Cardiol Year: 2023 Document type: Article