Key result
Planned rotational atherectomy is recommended over provisional rotational atherectomy for heavily calcified coronary lesions characterized by circumferential superficial calcium.
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Planned rotational atherectomy, ideally assessed with intravascular ultrasound, is recommended over a provisional approach for managing heavily calcified coronary lesions.
Key Points Rotational atherectomy (RA) with Rotablator is highly effective for modifying heavily calcified coronary artery lesions to facilitate stent expansion. Fluoroscopic assessment of the extent and depth of calcium is unreliable, and the best assessment is achieved with intravascular ultrasound. Planned RA is the percutaneous treatment of choice for heavily calcified lesions characterized by circumferential superficial calcium; provisional RA in these patients should be avoided.
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Robert D. Safian (2016) conducted an editorial in Heavily calcified coronary artery lesions. Planned rotational atherectomy vs. Provisional rotational atherectomy was evaluated. Planned rotational atherectomy is recommended over provisional rotational atherectomy for heavily calcified coronary lesions characterized by circumferential superficial calcium.
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