Rotational coronary atherectomy of coronary arteries: modern trends

Authors: Petrosian K.V., Abrosimov A.V., Karaev A.V., Gurdzibeev A.B.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

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Type:  Reviews


DOI: https://doi.org/10.24022/1997-3187-2022-16-3-313-325

For citation: Petrosyan K.V., Abrosimov A.V., Karaev A.V., Gurdzibeev A.B. Rotational coronary atherectomy of coronary arteries – modern trends. Creative Cardiology. 2022; 16 (3): 313–25 (in Russ.). DOI: 10.24022/1997-3187-2022-16-3-313-325

Received / Accepted:  28.07.2022 / 16.09.2022

Keywords: rotational atherectomy atherosclerotic plaque calcification

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Abstract

Rotational atherectomy (RA) is a technology that allows for percutaneous coronary interventions (PCI) in complex calcified lesions of the coronary arteries. RA works on the principle of “differential cutting” and preferably removes the hard, inelastic component of the atherosclerotic plaque. Currently, surgeons have moved away from the isolated use of RA and the purpose of its application is currently to modify the plaque to enable adequate balloon angioplasty and optimal stent implantation. This led to a significant improvement in procedural safety, a reduction in the number of concomitant complications and a positive effect on the long-term results of interventions. This article analyzes the world literature, the history of the development of the method from its invention to routine application in daily practice, and also examines current data on general principles, technical aspects and complications in the form of perforation of the target coronary artery, drill jam, the development of slow/no-reflow syndrome associated with the use of rotational atherectomy techniques. Coverage of the basic principles and techniques of RA for inexperienced specialists will help to avoid possible intraoperative complications, and with their development – to overcome and/or minimize their consequences, improving the quality of medical care.

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About Authors

  • Karen V. Petrosian, Dr. Med. Sci., Head of Department; ORCID
  • Andrey V. Abrosimov, Cand. Med. Sci., Researcher; ORCID
  • Aslanbek V. Karaev, Cand. Med. Sci., Junior Researcher; ORCID
  • Alan B. Gurdzibeev, Postgraduate; ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery