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Coronary atherectomy modifies and debulks calcified plaque to facilitate PCI. Although there is no clear consensus, and further studies are needed, the decision to perform atherectomy should be based upon the presence of fluoroscopic CAC or with the use of intravascular imaging. The management of CAC in the modern era relies on rotational and orbital atherectomy to prepare the lesion to facilitate stent delivery and optimal expansion. While the two technologies differ in equipment, technique, and mechanism of action, the available literature suggests similar efficacy and safety of the two systems, although head\u2010to\u2010head comparisons are limited. While rotational and orbital atherectomy have been shown to have excellent procedural success in terms of facilitating stent delivery, no system has been shown to reduce long\u2010term major adverse cardiovascular events, although the definitive trial for orbital atherectomy has not been completed. Additional trials are needed to find the population who would derive the most benefit of atherectomy and to compare the two systems in a prospective manner.<\/jats:p>","DOI":"10.1002\/ccd.27339","type":"journal-article","created":{"date-parts":[[2017,10,17]],"date-time":"2017-10-17T11:26:38Z","timestamp":1508239598000},"page":"61-67","source":"Crossref","is-referenced-by-count":31,"title":["Orbital and rotational atherectomy during percutaneous coronary intervention for coronary artery calcification"],"prefix":"10.1002","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0714-4571","authenticated-orcid":false,"given":"Michael S.","family":"Lee","sequence":"first","affiliation":[{"name":"Division of Cardiology David Geffen School of Medicine at UCLA Los Angeles California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan S.","family":"Gordin","sequence":"additional","affiliation":[{"name":"Division of Cardiology David Geffen School of Medicine at UCLA Los Angeles California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregg W.","family":"Stone","sequence":"additional","affiliation":[{"name":"Columbia University Medical Center\/New York\u2013Presbyterian Hospital and the Cardiovascular Research Foundation New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samin K.","family":"Sharma","sequence":"additional","affiliation":[{"name":"Mount Sinai Hospital New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9560-1228","authenticated-orcid":false,"given":"Shigeru","family":"Saito","sequence":"additional","affiliation":[{"name":"Shonan Kamakura General Hospital Kamakura Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ehtisham","family":"Mahmud","sequence":"additional","affiliation":[{"name":"UC San Diego Medical Center La Jolla California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeff","family":"Chambers","sequence":"additional","affiliation":[{"name":"Metropolitan Heart and Vascular Institute, Mercy Hospital Roslyn New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"G\u00e9n\u00e9reux","sequence":"additional","affiliation":[{"name":"Columbia University Medical Center\/New York\u2013Presbyterian Hospital and the Cardiovascular Research Foundation New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Shlofmitz","sequence":"additional","affiliation":[{"name":"St. Francis Hospital Roslyn New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,10,17]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.91.7.1959"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.580696"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/2047487314564727"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.02.088"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-14-0108"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.86.1.64"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.carrev.2005.08.008"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2016.02.012"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.109.852178.109.852178"},{"key":"e_1_2_9_11_1","first-page":"e46","article-title":"2011 ACCF\/AHA\/SCAI guidelines for percutaneous coronary intervention. 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