Rotational Atherectomy for Coronary Chronic Total Occlusion With Severe Calcification: A Preliminary Study

Objective: The aim of this study was to investigate the therapeutic effects and 1‐year outcomes of RA in patients with severe calcified coronary artery CTO. Methods: Data were collected from 395 individuals with severe calcified CTO who received treatment at Liaoning Provincial People’s Hospital. These patients were categorized into two groups: those receiving RA and those receiving non‐RA. The association between RA and the incidence of MACCEs within the 1‐year postoperative period was evaluated via the Cox proportional hazards model. Results: In patients with CTO exhibiting severe calcification, we compared various factors, including age, BMI, history of diabetes, left ventricular ejection fraction, low‐density lipoprotein levels, hemoglobin, creatinine, the glomerular filtration rate, and family history of coronary heart disease, between those who underwent RA and those who did not. In addition, we assessed medical history, cardiac bypass surgery, cerebrovascular disease, coronary interventions, the number of CTO lesions, operation time, irradiation time, contrast agent usage, and the incidence rates of MACCEs, all of which were found to be statistically significant ( p < 0.05). These significant indicators and the occurrence of MACCEs within 1 year were incorporated into the Cox survival regression analysis, which revealed that the use of RA ( p = 0.010, HR: 0.457, 95% CI: 0.251–0.830) was independently correlated with a lower MACCE rate. Furthermore, the survival curve of the non‐RA group was significantly lower than that of the RA group. Conclusion: Intervention with RA is associated with a lower MACCE rate in patients with severely calcified CTO. These findings imply that the potential of RA could be an alternative treatment modality in these patients. However, more evidence and further randomized controlled studies are needed to verify these findings.