Coronary disease & ACSRandomised controlled trial
Rotational Atherectomy, Lithotripsy, or Laser for Calcified Coronary Stenosis
- Randomised controlled trial
- non-inferiority
Authors' conclusion
In the first randomized trial comparing RA, IVL, and ELCA for the treatment of patients with calcified coronary lesions, IVL was noninferior to RA in terms of stent expansion. ELCA did not reach this noninferiority margin compared with RA. No significant differences were observed among the 3 arms regarding minimum stent area, procedural success rate, and complications, which were numerically lower with IVL.
Study context
- Population
- Patients with moderate to severe calcified coronary lesions undergoing PCI
- Participants
- 171 patients
- Comparison
- Intravascular lithotripsy (IVL) or excimer laser coronary angioplasty (ELCA) vs rotational atherectomy (RA) before PCI
- RAn = 57reference
- IVLn = 57
- ELCAn = 57
- Primary endpoint
- Percentage of stent expansion by optical coherence tomography
Primary result
As reported in the abstract
Stent expansion
P = 0.77
Further findings
Final minimum stent area
Final minimum stent area
- Procedural success rate and final minimum stent area similar among the 3 arms
Safety
Complications
- Low rate, no significant differences among the 3 arms, numerically lower with IVL
Original publication
Rotational Atherectomy, Lithotripsy, or Laser for Calcified Coronary Stenosis. JACC Cardiovasc Interv. Published 5 February 2025. doi:10.1016/j.jcin.2024.11.012
Summarised from the published abstract; every number is checked against it