Enhanced Efficacy of Rotational Atherectomy for Calcified Nodules With Contralateral Calcification: Insights From a Multicenter Intravascular Ultrasound Imaging Study
Main finding · TLRResult — go to the resultHazard ratio 0.34 95% CI 0.19–0.62Authors' 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
- Outcome
- TLR
- Follow-up
- Median 2.1 years (interquartile range, 0.4-4.9)
Methodological detailssubstudy of the U-SCAN registry
- Substudy of the U-SCAN registry
Main finding
As reported in the abstract
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
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.
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