Rotablation, also known as Rotational Atherectomy, is a specialized coronary intervention used to treat severely calcified and hard coronary artery blockages that cannot be adequately dilated with routine balloons. It enables safe and effective stent delivery in complex coronary artery disease.
Rotablation modifies severely calcified plaques, allowing safe balloon expansion and optimal stent deployment in complex coronary arteries.
Calcified coronary lesions are commonly seen in elderly patients, long-standing diabetes, chronic kidney disease, prior failed angioplasty, and left main or bifurcation disease. In such cases, routine balloons and stents may fail without adequate plaque modification.
- Elderly patients with severe coronary calcification
- Long-standing diabetes or chronic kidney disease
- Balloon-uncrossable or balloon-undilatable lesions
- Prior failed angioplasty due to heavy calcium
- Left main or bifurcation disease with dense calcification
- Prevention of stent under-expansion and failure
How Rotablation Is Performed
Rotablation is a precision procedure designed for plaque modification rather than plaque removal, performed in advanced cardiac catheterization laboratories.
Rotablation uses a diamond-coated rotating burr that spins at 140,000–180,000 rpm to sand down calcified plaque into microparticles smaller than 5 microns while preserving vessel elasticity.
By modifying hard calcium, rotablation makes the lesion compliant, allowing proper balloon dilatation and optimal drug-eluting stent expansion.
Rotablation is indicated for heavily calcified coronary lesions, stent under-expansion due to calcium, left main disease, and complex bifurcation lesions.
Rotablation enables successful stent delivery, improves stent expansion and long-term patency, reduces restenosis and stent thrombosis, and avoids bypass surgery in selected patients.
In experienced centers, rotablation has high procedural success with low complication rates, especially when guided by IVUS or OCT imaging.
Expert Rotablation & Complex PCI
Advanced rotablation combined with IVUS/OCT-guided PCI for optimal plaque modification, safe stent deployment, and durable long-term outcomes in complex coronary disease.
