Orbital Atherectomy in Calcified Coronary Lesions: a 1-year retrospective observational outcome study

Abstract

Background Percutaneous coronary intervention (PCI) has advanced rapidly since its inception. Not only in stent technology, but there have been advancements in adjunctive tools including intra-coronary imaging, stent delivery tools and calcium modification techniques. The interventional community is well aware of the difficulties posed by calcified coronary lesions and their impact on outcomes. More recently, orbital atherectomy (OA) has seen itself on the fore front of managing such complex and challenging situations. Aims This retrospective study analyses a 1-year experience of using OA in a high-volume primary PCI center in a UK district general hospital. Methods Patient demographics, procedural details, and outcomes, including MACE rates and procedural success, were reviewed in all-comers undergoing OA between January 1 and December 31, 2024. Results A total 53 patients were identified that had undergone OA in a 1-year period. Procedural success was achieved in 98.1% of patients. Thirty-days MACE was 5.7% (three patients). One patient experiencing in-hospital procedural related myocardial infarction and two patients had major bleeding events during the follow up period which is not related to OA. No-flow/slow-flow were observed in seven patients (13.2%), and seven patients (13.2%) experienced coronary dissection that were successfully treated with stent implantation. Conclusion OA is a new but safe and effective tool for calcium modification in an all-comers cohort of patients treated in a high-volume UK district general hospital setting.