The decision to perform the PCI was either based on a judgment made by the Heart Team or on a particular clinical indication (ongoing ischemia, lack of will for the alternative treatment options). All procedures were performed between January 2014 and June 2021. The subjects in this study were carefully selected from all consecutive patients with calcified lesions who had undergone PCI, and who required additional lesion preparation with either Rotational Atherectomy or Shock Wave Intravascular Lithotripsy for LM diseases (main inclusion criteria to study). The study presents a retrospective analysis of a dataset from a registry conducted in two cooperative, high-volume PCI cardiac centers (Department of Cardiology, The Copper Health Centre (MCZ), Lubin, Poland and Department of Cardiology, Provincial Specialized Hospital, Legnica, Poland).

Further studies with a higher number of participants and longer follow-up times are warranted to establish the potential benefits of RA and S-IVL for the management of LM stenosis. Conclusions: RA and S-IVL could be safe and effective therapeutic strategies for calcified LM disease. The S-IVL group was composed of 15 subjects with a syntax score of 23.3 ± 13.0 There were no statistical differences regarding MACE between the RA and Shockwave arms of the in-hospital group (10.3% vs. Results: The Rota group consisted of 29 patients with a mean syntax score of 28.0 ± 7.5. Methods: We performed a retrospective evaluation of 44 consecutive subjects who underwent the LM-PCI, and who were supported by either the RA or S-IVL. Recently, the novel ShockWave-Intravascular-Lithotripsy(S-IVL) device has been introduced to the PCI armamentarium in order to modify the calcified plaque.

Rotational Atherectomy (RA) is a well-established plaque-modifying method nevertheless, the data regarding the effectiveness of RA in LM diseases is scarce. Adequate lesion preparation plays a crucial role in achieving a favorable PCI outcome. Background: The unprotected calcified Left Main disease represents a high-risk subset for percutaneous coronary intervention (PCI), and it is associated with a higher number of periprocedural complications and an increased rate of in-stent thrombosis and restenosis.

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