{
  "abstract": "Introduction Coronary artery calcification (CAC) is associated with poor outcomes in patients undergoing percutaneous coronary intervention (PCI). 1Rotational atherectomy (RA) and orbital atherectomy (OA) are two ways to manage CAC.2 Methods A systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines. PubMed was searched from January 2000 to July 2025. Eligible studies reported comparisons between OA and RA in the management of patients with severe CAC. Data was synthesised quantitatively and narratively. The Newcastle-Ottawa scale was used to assess risk of bias in observational studies, and the Cochrane Risk of Bias Tool was used for randomised controlled trials.Results No significant differences were found in short-term major adverse cardiovascular events (MACE), cardiac mortality, long-term non-fatal myocardial infarction (MI), or short-term target vessel revascularisation (TVR). RA was associated with higher long-term MACE (OR: 1.52, 95% CI: 1.02–2.27), long-term TVR (OR: 2.55, 95% CI: 1.14–5.71), short-term non-fatal MI (OR: 1.75, 95% CI: 1.05–2.92), and short- and long-term all-cause mortality (OR: 1.61 and 3.98, respectively). However, RA showed lower rates of coronary dissection (OR: 0.36, 95% CI: 0.29–0.45) and cardiac tamponade (OR: 0.34, 95% CI: 0.25–0.46). No differences were found in slow-flow/no-reflow, device-induced perforation, fluoroscopy time, or contrast volume.Conclusion OA is associated with superior long-term outcomes, while RA demonstrated fewer procedural complications, highlighting the need for individualised device selection based on patient and lesion characteristics.References Virmani R, Burke AP, Farb A, Kolodgie FD. Pathology of the vulnerable plaque. J Am Coll Cardiol. 2006;47(8 Suppl):C13-C18. Khan MH, Ahmed Z, Fatima B, et al. Rotational versus orbital atherectomy for treating heavily calcified coronary lesions: a meta-analysis. Catheter Cardiovasc Interv. 2020;96(6):1242–1249.",
  "authors": [
    {
      "affiliations": [
        "East Lancashire Hospitals NHS Trust"
      ],
      "name": "Eyad Jamileh"
    },
    {
      "affiliations": [
        "School of Medicine, University of Sheffield, Sheffield, UK"
      ],
      "name": "Ahmed Elmewafy"
    },
    {
      "affiliations": [
        "Imperial College Healthcare NHS Trust, London, UK"
      ],
      "name": "Abdelmadjid Zinet"
    },
    {
      "affiliations": [
        "School of Medicine, Queen Mary University of London, London, UK"
      ],
      "name": "Umar Faruq Ali"
    },
    {
      "affiliations": [
        "Sandwell and West Birmingham NHS Trust, Birmingham, UK"
      ],
      "name": "Usama Al Bouche Ade"
    },
    {
      "affiliations": [
        "Princess Alexandra Hospital NHS Foundation Trust, Harlow. UK"
      ],
      "name": "Ahmed Ali Kayyale"
    },
    {
      "affiliations": [
        "Department of Cardiovascular Sciences, Clinical Science Wing, University of Leicester, Glenfield Hospital, Leicester, UK"
      ],
      "name": "Ibrahim Antoun"
    }
  ],
  "title": "P23  Comparing rotational and orbital atherectomy for the treatment of calcified coronary lesions: an updated systematic review and meta-analysis",
  "uid": "df005e1b-f559-52e1-beda-46f7c47aea88"
}