Tips and Tricks of Orbital Atherectomy in Real-World Clinical Practice

Orbital atherectomy (OA) is a highly effective atherectomy device used to treat heavily calcified coronary arteries. The technique for using OA is critical and depends on appropriate use of the dedicated guidewire. OA employs a centrifugal, differential sanding mechanism with bidirectional movement. When used with proper technique, the device appears to be associated with a low rate of complications, such as bradycardia and slow flow, compared with rotational atherectomy (RA), and results in high procedural success rates. We describe our experience with the OA device and procedural techniques in our catheterization laboratory.