"RotaTripsy" for severe calcified coronary artery lesions: Insights from a real-world multicenter cohort.

Abstract Objectives The aim of this study is to assess the feasibility, efficacy and safety of the “RotaTripsy” approach in severe calcified coronary artery lesions. Background Coronary lesions with a high calcium content represent a challenging scenario in interventional cardiology , requiring a proper lesion preparation. In this light, very little is known about the possibility to combine the benefits of rotational atherectomy and intravascular lithotripsy . Methods We retrospectively enrolled 34 patients from a real-word, multicenter, cohort of patients affected by severe calcified coronary artery lesions, which required the “RotaTripsy” to obtain a proper lesion preparation. In all the cases, rotational atherectomy and then intravascular lithotripsy were performed as a bail-out strategy following sub-optimal non-compliant balloon expansion. In 53% of the cases, the procedure was guided by intracoronary imaging findings. Results Procedural success was reported in all the cases, without any in-hospital major complication. Few major adverse clinical events were reported at mid-term follow-up. Conclusions “RotaTripsy” can represent a valid therapeutic option for undilatable heavily calcified coronary artery lesions. Our findings demonstrate the feasibility, safety and efficacy of this approach.