ROtablation of calcified Coronary artery lesions - The ISAR ROCK Registry

Coronary artery calcification (CAC) is associated with higher rates of adverse cardiovascular events in patients undergoing percutaneous coronary intervention (PCI). Debulking-techniques like rotational atherectomy (rotablation) offer the potential for enhanced lesion preparation which may result in lower stent failure rates in the specific setting of CAC. Whether rotablation improves short- and long-term clinical outcomes of patients with calcified lesions needs to be further investigated.

To evaluate the efficacy and safety of rotablation based PCI of calcified coronary artery lesions. 

We performed a retrospective analysis of patients who underwent rotablation-based PCI between February 2012 and February 2023 at a German PCI center . Clinical endpoints were all-cause death, target lesion revascularization (TLR), myocardial infarction (MI), probable or definite stent thrombosis after PCI.

679 patients with 1023 lesions with moderate to severe CAC, who underwent rotablation based PCI, were included in this analysis. The mean age was 74.5±8.8 years and 35.8% were diabetics. In 22.4% of cases patients presented with acute-coronary syndromes, 28.0% had prior MI and 20.0% had prior bypass surgery. 

At 12 months follow up, 90% of patients were alive. Target lesion revascularization rate was 11.65%. Only 1.05% of TLR events occurred within the first 30 days. Concerning thrombotic events, myocardial infarction rate was 1.94% at 30 days and 2.09% at 1 year, respectively. The rate of definite or probable stent thrombosis was: 2.26% at 30 days and 2.57% at 1 year, respectively.