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Coronary disease & ACSMechanistic study

Enhanced Efficacy of Rotational Atherectomy for Calcified Nodules With Contralateral Calcification: Insights From a Multicenter Intravascular Ultrasound Imaging Study

Circ Cardiovasc IntervPublished

  • Multicenter Intravascular Ultrasound Imaging Study
  • substudy of the U-SCAN registry
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Authors' conclusion

In patients with CNs, RA was associated with a reduced long-term risk of TLR. The presence of contralateral calcification identifies a subgroup deriving substantial benefit, supporting a more selective, morphology-guided approach to treatment.

Study context

Population
Patients with calcified nodules (CNs) identified by intravascular ultrasound who underwent percutaneous coronary interventionfinal analysis, 348 patients analyzed before exclusions
Participants
209 patients
Comparison
Rotational atherectomy (RA) use vs no RA
  • RA groupn = 79
  • non-RA groupn = 130

Main finding

TLR · median follow-up of 2.1 years (interquartile range, 0.4-4.9)

Hazard ratio

0.34

95% CI 0.19–0.62

P < 0.001

Events by group

RA use vs no RA
hazard ratio 0.34 (95% CI 0.19–0.62); P < 0.001

As reported in the abstract

Further findings

TLR, patients with contralateral calcification (subgroup)

TLR, patients without contralateral calcification (subgroup)

  • Target lesion revascularization (TLR), patients with contralateral calcification (subgroup): P <0.001
  • TLR, patients without contralateral calcification (subgroup): P =0.11
  • TLR, patients without contralateral calcification (subgroup): P interaction <0.001

Intravascular ultrasound-derived calcification features associated with TLR

greater lumen area stenosis, longer CN length, smaller final minimum lumen area, and adjacent circumferential calcification were significantly associated with TLR

Original publication

Enhanced Efficacy of Rotational Atherectomy for Calcified Nodules With Contralateral Calcification: Insights From a Multicenter Intravascular Ultrasound Imaging Study. Circ Cardiovasc Interv. Published 11 February 2026. doi:10.1161/circinterventions.125.015932
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Summarised from the published abstract; every number is checked against it