Orbital atherectomy reasonable strategy for treatment of severely calcified ostial and non-ostial lesions
A study published in Cardiovascular Revascularization Medicine on 20 July 2023 entitled, "Orbital atherectomy safety and efficacy: A comparative analysis of ostial versus non-ostial calcified coronary lesions” by Ghazzal et al. has concluded that there are no significant differences in in-hospital major adverse cardiovascular events or MACE outcomes between patients with ostial versus non-ostial lesions. This indicates that orbital atherectomy, or Orbital atherectomy is a safe and effective treatment option for both lesion types. This also includes those classified as aorto-ostial.
Explaining the study background, they said there needs to be more demonstration on the safety and efficacy of Orbital atherectomy for managing ostial lesions. In this study, researchers evaluated OA treatment of severely calcified ostial and non-ostial lesions in a retrospective analysis of those treated with OA for severely calcified ostial and non-ostial lesions.
The key Results of the study are:
- Researchers identified 609 patients who underwent PCI with OA.
- The participants were 63 % males aged 74 years (mean age).
- 81.9 % of patients had non-ostial lesions.
- The ostial lesions were present in 16.6 % of patients, and 2.8 % were aorto-ostial.
- 1.5 % of patients had unknown lesion anatomy.
- All patients received drug-eluting stent (DES) placement, and the overall freedom from MACE was 98.5 %,
- There was no difference between the ostial and non-ostial groups.
- There were similarities between the groups about freedom from cardiac death and MI.
- Researchers recorded low rates of bleeding complications and severe angiographic complications.
- There was no persistent slow flow/no-reflow reported.
Concluding further, they said our study had limitations like limited generalizability and less experienced non-tertiary centres, analysis of only in-hospital data and no reflection of long-term outcomes of patients.
This study found that using Orbital atherectomy for both ostial and non-ostial coronary artery disease patients was related to favourable in-hospital freedom from major adverse cardiovascular events (MACE) rates, low bleeding rates, and severe angiographic complications.
Further reading:
https://www.sciencedirect.com/science/article/abs/pii/S1553838923007108
