B-27 | Rotational vs. Orbital Atherectomy Procedural Outcomes: A NCDR Data Registry Study

Abstract

Rotational (RA) and orbital (OA) atherectomy for severely calcified coronary artery lesions (CCAS) may improve overall clinical outcomes. Little recent data comparing in-hospital outcomes between these methods exists. Patients undergoing OA or RA between 2016-2021 at 7 IU Health Hospitals were identified in the Indiana University Health Multicenter Cath Registry. Data was collected as defined by the National Cardiovascular Data Registry. Outcomes were analyzed by age, treated lesion length (TLL), and left ventricular ejection fraction (LVEF). In total, 868 patients (210 RA and 658 OA) were analyzed. RA and OA patients had similar age (RA: 50.6±11.27 years, OA: 51.2±9.88 years, p=0.51), TLL (RA: 41.2±25.49 mm, OA: 42.32±23.9 mm, p=0.56), and LVEF (RA: 50.6±12.8%, OA: 51.2±14%, p=0.60). OA patients had more dyslipidemia (0.91±0.28, p=0.02) and RA patients had higher rate of prior coronary intervention (0.62±0.49, p<0.001). Outcomes between RA and OA groups were not statistically significant (Table 1). On subgroup analysis, RA patients with LVEF < 35% had significantly more cardiac tamponade events (0.05±0.21, p=0.046). This retrospective multicenter analysis demonstrates that OA and RA have comparable clinical and procedural outcomes and are equally safe and effective in our institutions. Overall, events were low in both groups, but operators used OA 3.1 times more often to treat CCAS.