Adjunctive Technologies (Rotablation, Excimer Laser, Aspiration Thrombectomy, Distal Embolic Protection)

Rotational atherectomy improves the procedural success rate of percutaneous coronary intervention (PCI) in heavily calcified lesions, but does not decrease restenosis. Late lumen loss was higher in patients treated with rotational atherectomy followed by drug-eluting stenting compared with patients without rotational atherectomy. Pericardiocentesis kits and covered stents should be readily available given the risk of coronary perforation.