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Clinical Outcomes Following Atherectomy of Calcified Left Main Coronary

Lookup NU author(s): Dr Ayman Al-atta, Dr Bilal Bawamia, Dr Mohammad Alkhalil, Dr Mohaned Egred

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).

Abstract

Copyright © 2025 Mohamed Farag et al. Journal of Interventional Cardiology published by John Wiley & Sons Ltd.Introduction: Plaque modifying-debulking devices are the most effective initial strategy for percutaneous coronary intervention of severely calcified lesions including left main coronary artery. There are limited data comparing the short- and long-term clinical outcomes of these devices in left main lesions. Methods: A retrospective analysis of patients with calcified left main lesions treated with percutaneous intervention with adjunctive plaque modifying device at a large tertiary center between 2008 and 2021. The primary endpoint was long-term mortality at documented longest follow-up. Secondary endpoints included procedural complications and in-hospital clinical outcome. Results: A total of 302 patients with calcified left main lesions treated with rotational atherectomy (RA) (n = 240), intracoronary lithotripsy (n = 30), or excimer laser coronary atherectomy (n = 32) were included. Out of all patients, 55% presented with acute coronary syndromes. Technical success was achieved in 98.7% of the patients and procedural success was achieved in 95.4% of the patients. At a median follow-up of 42 (19–62) months, there was no difference in mortality between the 3 devices (RA 54/240 [23.4%] vs. lithotripsy 1/30 [3.3%] vs. laser 5/32 [15.6%], p = 0.128). Likewise, in-hospital clinical outcomes were similar. However, procedural complications were higher in the laser group. Conclusions: In patients with calcified left main lesions treated with percutaneous intervention, adjunctive plaque-modifying devices appear safe with survival exceeding 80% at long-term follow-up with no difference between the devices in relation to in-hospital clinical outcomes or long-term mortality risk.

Publication metadata

Author(s): Farag M, Gungoren F, Al-Atta A, Abdalazeem I, Bawamia B, Alkhalil M, Egred M

Publication type: Article

Publication status: Published

Journal: Journal of Interventional Cardiology

Year: 2025

Volume: 2025

Issue: 1

Online publication date: 14/07/2025

Acceptance date: 16/06/2025

Date deposited: 28/07/2025

ISSN (print): 0896-4327

ISSN (electronic): 1540-8183

Publisher: John Wiley and Sons Inc

URL: https://doi.org/10.1155/joic/9605550

DOI: 10.1155/joic/9605550

Data Access Statement: The data that support the findings of this study are available from the corresponding author upon reasonable request

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