Role of Rotational Atherectomy in Percutaneous Coronary Interventions in Elderly

RA is a debulking device that physically removes plaque and reduces plaque rigidity basically altering vessel compliance, similar to that achieved by a dental drill. It works on the principle of “differential cutting”, ablating only the calcified and fibrotic “non-compliant” tissue, while retaining the elastic arterial wall. The hard and calcified plaque is not able to deflect the rota-burr and gets ablated producing microfissures at the contact zone. The “ablated” plaque is broken into particles that are smaller than 5uM in diameter that pass through the vasculature and absorbed by the Reticulo-Endothelial System [4].