Outcomes of an enhanced percutaneous coronary intervention combining orbital and rotational atherectomy for calcified lesions: A case series report

Coronary artery calcification is significantly associated with major adverse cardiac events in patients with coronary artery disease. However, percutaneous coronary intervention (PCI) for calcified lesions presents challenges. This report presents a series of 20 cases that underwent intravascular imaging-guided PCI using a combination therapy involving an orbital atherectomy system (OAS) followed by rotational atherectomy (RA) specifically designed to address calcified lesions. Intravascular imaging during OAS allowed the use of guidewire bias to the calcified lesion, thereby allowing targeted ablative therapy using RA. These findings suggest that this approach significantly reduces the risk of slow flow compared with the use of a large burr in RA monotherapy, offering a safer and more effective treatment method.