Comparison of rotational and orbital atherectomy: A systematic review of efficacy and safety in patients who underwent percutaneous coronary intervention

Abstract

Background: To assess the clinical results of CAD patients who underwent orbital atherectomy (OA) and rotational atherectomy (RA). Methods: PICO criteria for publication in the last 5 years and preferred reporting elements for systematic reviews and meta-analyses (PRISMA) were used to systematically choose publications. Boolean operators were used to search for keywords. The effectiveness of each chosen article was evaluated using the STROBE checklist. Results: Five articles of non-randomized observational analysis were selected, which involved 72.982 patients whom underwent RA, while 6.431 others underwent OA which is a new atherectomy method that was approved for use in coronary arteries in 2003. Although some studies still showed varying results due to different data collection tools, overall data showed there was no difference between the two techniques in terms of contrast volume, outcomes of coronary artery dissection, periprocedural myocardial infarction (MI), arterial perforation caused by device, cardiac tamponade, in-hospital mortality, slow flow/no reflow, 30-day of mortality, target vessel revascularization (TVR), MI and major adverse cardiovascular events (MACE). The burr size and rotational speed for RA may lead to complication rates. Conclusion: Except for a shorter fluoroscopy time with OA, there are no discernible differences between OA and RA in patients with calcified CAD undergoing PCI.