“RotaTripsy” as State-of-the-Art Strategy for Coronary Artery Calcification: A Scoping Review

Background: Recently, the combination of rotational atherectomy (RA) with intravascular lithotripsy (IVL), known as “RotaTripsy,” has been employed in the treatment of coronary lesions with severe calcification. In this article, we provide an overview of the current evidence regarding this technique, emphasizing the importance of appropriate patient and lesion selection to achieve optimal clinical outcomes, including the primary goal of improvement of stenting and enhancement of short and long-term prognosis.

Methods: We performed a systematic literature search using PubMed, Embase, Web of Science, and Cochrane library up to July 2024 for studies that combined RA and IVL for coronary artery calcification lesions that were included. The retrieved articles and references of the primary articles were used to collect the basic information. SPSS 20.0 and Excel statistic software were used to conduct this scoping review.

Results: A total of 25 studies consisting of 259 patients were identified. Of all the patients, 208 (80.3%) were male. Patients had an average age of 68.31 years, and 119 (45.95) patients had acute coronary syndrome. In addition, 218 (84.17%) had hypertension, 128 (49.42%) had diabetes mellitus, and 48 (18.53%) had chronic kidney disease. In the ultimate analysis, 252 patients (97.3%) successfully underwent the “RotaTripsy” procedure, with a minimal mortality rate of only 7 individuals (2.7%) during the follow-up period.

Conclusions: “RotaTripsy,” as an efficacious therapeutic modality, shows its unique potential for severe calcified coronary artery lesions resistant to dilation. Our research findings substantiate its feasibility, safety, and effectiveness in clinic.