Article highlights effects of orbital atherectomy and rotational atherectomy in treating heavily calcified coronary lesions


An article e-published in in Catheterization and Cardiovascular Intervention highlights the mechanical effect of orbital atherectomy and rotational atherectomy in treating heavily calcified coronary lesions.

The article, titled “Optical coherence tomography assessment of the mechanistic effects of rotational and orbital atherectomy in severely calcified coronary lesions,” details results from a study led by Annapoorna Kini, professor of Cardiology at the Mount Sinai Hospital and Icahn School of Medicine, and Director of the Cardiac Catheterization Lab at Mount Sinai Hospital, USA.

Study co-investigator, Samin K Sharma, director of Clinical and Interventional Cardiology at The Mount Sinai Medical Center, said “We found that using orbital atherectomy versus rotational atherectomy to treat heavily calcified coronary lesions resulted in more significant tissue modification leading to better stent apposition and expansion. This may translate to lower or MACE, and restenosis rates.”

Kini’s study sought to assess the mechanical effects of rotational atherectomy and orbital atherectomy on heavily calcified coronary lesions and subsequent stent placement using optical coherence tomography, an established medical imaging technique that uses light to capture three-dimensional images from within arteries and other biological tissue. The retrospective analysis included 20 consecutive patients who were treated with either rotational atherectomy or orbital atherectomy. While small case reports have described the mechanistic effect of rotational atherectomy in calcified coronary lesions, there has been no imaging study to assess the effect of orbital atherectomy on coronary artery architecture and/or compare the effects of two atherectomy devices.

David L Martin, president and chief executive officer of Cardiovascular Systems, said, “These results illustrate that orbital atherectomy delivers less stent malapposition and better stent placement and expansion. Similarly, our ORBIT II study results showed successful stent delivery in 98% of the procedures, with 96% freedom from severe angiographic complications post orbital atherectomy. Two-year ORBIT II results also showed a 94% freedom from target lesion revascularisation and 81% freedom from MACE. We are excited by the growing clinical evidence supporting the procedural success of the Diamondback 360 orbital atherectomy system in severe coronary calcium.”