Coronary disease & ACSRandomised controlled trial
Direct Comparison of Rotational vs Orbital Atherectomy for Calcified Lesions Guided by Optical Coherence Tomography
- Randomised controlled trial
- prospective
- 1:1 randomisation
Authors' conclusion
The prospective randomized DIRO trial revealed that RA could produce a more favorable tissue modification, which may lead to a larger stent expansion than OA in heavily calcified lesions.
Study context
- Population
- Patients with de novo calcified coronary lesions (arc >180° by optical coherence tomography (OCT), or angiographically moderate or severe calcification if the OCT catheter could not cross)
- Comparison
- OCT-guided PCI with rotational atherectomy vs orbital atherectomy
Primary result
As reported in the abstract
Stent expansion (minimum stent area / distal reference area × 100)
P = 0.02
Further findings
Maximum atherectomy area
P = 0.004
Vascular healing by OCT · 8 months
- Vascular healing sufficient in both groups
Safety
Procedural outcomes (incl. periprocedural MI) and clinical events · 8 months
- Did not differ between the groups
Original publication
Direct Comparison of Rotational vs Orbital Atherectomy for Calcified Lesions Guided by Optical Coherence Tomography. JACC Cardiovasc Interv. Published 11 September 2023. doi:10.1016/j.jcin.2023.06.016
Summarised from the published abstract; every number is checked against it