Comparison of long-term outcomes between NCB and NCSB in heavily calcified CAD after rotablation

Introduction: Scoring balloons are an important calcium modification tool. Its use after rotablation results in better clinical outcomes. The aim of this study was to compare clinical outcome between use of non-complaint balloon and non-complaint scoring balloon after rotablation.

Methods: This prospective observation study was carried in the department of cardiology at National Heart Foundation Hospital & Research Institute from January 2015 to May 2025. All patients with heavily calcified lesion undergoing rotablation during this period were included in this study. After rotablation, lesions were prepared either with non-complaint balloon (NCB) or non-complaint scoring balloon (NCSB). Initially in person and subsequently telephonic follow-up was done.

Results: A total of 421 patients with heavily calcified lesion underwent rotablation. Of them, in 311 patients (73.9%) NCB was used for lesions preparation and in 110 patients (26.1%) NCSB was used. Mean follow-up was 53.18 ± 36.43 months and median follow-up was 52 months. Among patients in whom lesions were prepared with NCSB- 92.7% (102) were doing well; in- hospital death was 3.6% (4); follow-up death was 2.7% (3), MACCE (major adverse cardiac and cerebrovascular events) was 6.4%  and lost to follow-up was 0.9% (1). In contrarily, among patients in whom lesions were prepared with NCB- 68.2% (212) were doing well; in- hospital death was 2.6% (8); follow-up death was 21.5% (67), MACCE was 25.7% and lost to follow-up was 7.7% (24).

Conclusion: In comparison to NCB, non-complaint scoring balloon usage had better long-term clinical outcome after rotablation.

Key words: Heavily calcified lesions, non-complaint balloon, non-complaint scoring balloon, rotablation, clinical outcome.