Rotablator techniques in cardiac interventions

Prof. Dr. Georg Gaul is currently head of the 2nd Department of Internal Medicine at the Hanusch Hospitalin Vienna, Austria. He is former president of the Austrian Society of Cardiology and was also active as the head of the working group for interventional cardiology. Professor Gaul holds a position as the lecturer of the Medical University of Vienna, and he is also in charge as an international proctor for rotational atherectomy.

Abstract

After failed prospective RCT’ s in the late 1990’ies, use of rotational atherectomy has declined steadily to almost nil in most cath lab’s in the world. However, with the introduction of the new technology of drug eluting stents, audacity of interventionalists for doing difficult procedures has increased and indication for rotational atherectomy has regained common interest and ground, simultaneously. Comparing the baseline values, rotational atherectomy is used more in C-lesions, tighter, longer, more calcified, more fibrotic and morecomplex lesions [all p<0,001]. The use of the Rotablator pays off against the less sick not rotablated patient sample with at least statistically similar - numerically even slightly better- long term results measured by the hardest follow-up parameter, mortality, over more than 4 years. Besides this statistical outcome, rotational atherectomy helps with very tough cases to make the interventional procedure easier. Rotational Atherectomy is given nowadays the role of a hidden or forgotten “secret” tool for some intervention freaks.