Comparative analysis of the efficacy of rotational coronary atherectomy with drug-coated balloon and drug-eluting stent for severe calcified coronary artery disease

BACKGROUND: To evaluate the surgical effects and clinical follow-up outcomes of rotational atherectomy (RA) combined with drug-coated balloon (DCB) and drug-eluting stent (DES) in treating coronary artery calcification (CAC). METHODS: We retrospectively analyzed data from 272 patients with severe calcified coronary artery disease who underwent coronary RA combined with either DCB or DES. We compared preoperative and postoperative coronary imaging features and major adverse cardiac events (MACE) following surgery between patients treated with DCB and those treated with DES, and evaluated the differences in clinical efficacy within 1 year. RESULTS: There were no significant differences in baseline clinical data and preoperative coronary angiography characteristics between the DCB and DES groups. Regarding maximum expansion balloon diameter and pressure, the DES group showed higher values than the DCB group. However, the DCB group had a better procedure duration, contrast volume, and patient satisfaction. There was no significant difference in angina pectoris and cardiac death at the 1-year postoperative follow-up between the two groups. In addition, time to event analysis indicated a significant difference in the in-stent restenosis (ISR), stent thrombosis, and non-fatal myocardial infarction among both groups. CONCLUSION: For severe CAC, RA combined with DCB can be an effective supplement compared to RA combined with DES.