Evidence map›Paper›PMID 42501239›Full record

ArticleCardiovascular intervention and therapeutics2026

Physiological assessment of coronary microvascular dysfunction and short-term outcomes in severely calcified coronary lesions: a comparison between rotational atherectomy and intravascular lithotripsy.

Hirofumi Kusumoto, Daisuke Shishikura, Kenta Sakaguchi, Simpei Fujioka, Yohei Yamauchi, Tomohiro Fujisaka, Yumiko Kanzaki, Mariko Harada-Shiba, Hideaki Morita

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Article in Cardiovascular intervention and therapeutics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Hirofumi KusumotoDepartment of Cardiology, Osaka Medical and Pharmaceutical University Hospital, 2-7 Daigaku-Machi, Takatsuki-city, 569-8686, Osaka, Japan.ORCID http://orcid.org/0000-0001-8721-7680
Daisuke ShishikuraDepartment of Cardiology, Osaka Medical and Pharmaceutical University Hospital, 2-7 Daigaku-Machi, Takatsuki-city, 569-8686, Osaka, Japan. Daisuke.Shishikura@ompu.ac.jp.
Kenta SakaguchiDepartment of Cardiology, Osaka Medical and Pharmaceutical University Hospital, 2-7 Daigaku-Machi, Takatsuki-city, 569-8686, Osaka, Japan.
Simpei FujiokaDepartment of Cardiology, Osaka Medical and Pharmaceutical University Hospital, 2-7 Daigaku-Machi, Takatsuki-city, 569-8686, Osaka, Japan.
Yohei YamauchiDepartment of Cardiology, Osaka Medical and Pharmaceutical University Hospital, 2-7 Daigaku-Machi, Takatsuki-city, 569-8686, Osaka, Japan.
Tomohiro FujisakaDepartment of Cardiology, Osaka Medical and Pharmaceutical University Hospital, 2-7 Daigaku-Machi, Takatsuki-city, 569-8686, Osaka, Japan.
Yumiko KanzakiDepartment of Cardiology, Osaka Medical and Pharmaceutical University Hospital, 2-7 Daigaku-Machi, Takatsuki-city, 569-8686, Osaka, Japan.
Mariko Harada-ShibaDepartment of Cardiology, Osaka Medical and Pharmaceutical University Hospital, 2-7 Daigaku-Machi, Takatsuki-city, 569-8686, Osaka, Japan.
Hideaki MoritaDepartment of Cardiology, Osaka Medical and Pharmaceutical University Hospital, 2-7 Daigaku-Machi, Takatsuki-city, 569-8686, Osaka, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Coronary artery calcification (CAC), one of the greatest challenges of percutaneous coronary intervention (PCI), is associated with a poor prognosis. We therefore conducted a wire-derived physiological evaluation to investigate the influence of CAC modification using intravascular lithotripsy (IVL) and rotational atherectomy (RA) on the coronary circulation. A total of 154 patients with CAC requiring IVL or RA were enrolled in this single-center, retrospective study. Physiological assessments, particularly Index of microcirculatory resistance (IMR), coronary flow reserve (CFR), resistive reserve ratio (RRR), and microvascular resistance reserve (MRR) were performed using a temperature-sensor guidewire (Pressure Wire X, Abbott) pre- and post-PCI and compared between IVL and RA. Procedural and 30-day clinical outcomes were also evaluated. Seventy patients were treated with IVL and 84 with RA. IVL and RA demonstrated comparable lumen expansion. In the physiological assessments, RA significantly increased post-IMR compared to IVL (17.0 [10.5-32.8] vs.12.0 [9.00-19.0], p = 0.03), which was correlated with severity of periprocedural myocardial Infarction (MI) (Spearman's ρ = 0.40, p = 0.01). Post-CFR, post-RRR, and post-MRR were significantly higher with IVL than RA (3.20 [2.00-4.60] vs. 1.55 [1.20-2.10], p < 0.01, 2.90 [2.10-4.70] vs. 1.60 [1.20-2.42], p < 0.01, 2.77 [2.05-4.54] vs. 1.50 [1.20-2.37], p < 0.01, respectively). Use of RA was associated with post-PCI coronary microvascular dysfunction (OR: 4.77, 95% CI:1.51-17.56). Slow flow phenomenon and procedure-related MI were more frequently observed with RA than IVL (19.1% vs. 4.3%, p < 0.01, 35.7% vs. 7.1%, p < 0.01, respectively). In patients with severely calcified coronary lesions, IVL and RA achieved comparable epicardial results, whereas IVL was associated with more favorable post-procedural microvascular physiological indices than RA. Although RA was associated with increased procedural MI, this was not accompanied by a significant difference in short-term major adverse events. Further studies with large populations and long-term follow-up are warranted to determine the clinical significance of these physiological differences.

Indexed as

Calcium modificationCoronary microvascular dysfunctionIntravascular-lithotripsyRotational atherectomyWire-derived physiological evaluation

Identifiers

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.