{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T06:10:30Z","timestamp":1778998230155,"version":"3.51.4"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T00:00:00Z","timestamp":1751414400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T00:00:00Z","timestamp":1751414400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Plaque modification is crucial for successful stent expansion in calcified coronary lesions. Although rotational atherectomy (RA) improves initial procedural success compared to balloon predilatation, data comparing elective versus bailout RA, particularly in chronic kidney disease (CKD) patients, are scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To perform a cost analysis of elective RA (E\u2010RA) versus bailout RA (B\u2010RA) to treat severely calcified lesions in patients with CKD, comparing procedural material cost and total healthcare cost.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective, multicentre, randomized study compared the costs, safety, and efficacy of E\u2010RA versus B\u2010RA in severely calcified lesions in CKD patients. Participants were randomized 1:1. The primary endpoint was total healthcare cost at 30 days; secondary endpoints included procedural success, stent expansion, and in\u2010hospital complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      One hundred and twenty\u2010four patients were enrolled (62 per group). The mean age was 77.3\u2009\u00b1\u20098.3 years; 69.4% were male. There were no baseline clinical differences between both treatment arms. Procedural success was similar (B\u2010RA: 95.2% vs. E\u2010RA: 93.6%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.69), but crossover was higher in B\u2010RA (20.9% vs. 4.8%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014). Procedural complications were more frequent in the elective group (6.5% vs. 22.5%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04). The B\u2010RA group tended to higher balloon cost (2100.3 vs. 1485.1\u20ac;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.06), while E\u2010RA had higher burr costs (374.2 vs. 1408.8\u20ac;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) and tended toward higher stent costs (2396.7 vs. 2836.1\u20ac;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.06). Overall, procedural material costs were higher in E\u2010RA (6676.9 vs. 7683.3\u20ac;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02), but total healthcare costs were not significantly different (12569.1 vs. 14879.1\u20ac;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.09).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Total healthcare costs were comparable between B\u2010RA and E\u2010RA. A substantial number of patients with CKD and severe CAC required crossover from B\u2010RA, highlighting the potential benefit of E\u2010RA. Besides, the high number of complications underscores the need for expert operators.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.31730","type":"journal-article","created":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T04:54:47Z","timestamp":1751432087000},"page":"1702-1712","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Coronary Rotational Atherectomy Elective Versus Bailout in Patients With Severely Calcified Lesions and Chronic Renal Failure (CRATER) Trial"],"prefix":"10.1002","volume":"106","author":[{"given":"Guillermo","family":"Galeote","sequence":"first","affiliation":[{"name":"Cardiology Department La Paz University Hospital Madrid Spain"},{"name":"Fundaci\u00f3n de Investigaci\u00f3n IDIPAZ, Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBERCV) Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4744-4306","authenticated-orcid":false,"given":"Jon","family":"Zubiaur","sequence":"additional","affiliation":[{"name":"Cardiology Department La Paz University Hospital Madrid Spain"},{"name":"Fundaci\u00f3n de Investigaci\u00f3n IDIPAZ, Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBERCV) Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6362-7618","authenticated-orcid":false,"given":"Alfonso","family":"Jurado\u2010Rom\u00e1n","sequence":"additional","affiliation":[{"name":"Cardiology Department La Paz University Hospital Madrid Spain"},{"name":"Fundaci\u00f3n de Investigaci\u00f3n IDIPAZ, Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBERCV) Madrid 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Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julio","family":"Garc\u00eda\u2010Tejada","sequence":"additional","affiliation":[{"name":"Cardiology Department October Twelve University Hospital Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asier","family":"Subinas","sequence":"additional","affiliation":[{"name":"Cardiology Department Galdakao\u2010Usansolo University Hospital Basque country Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcos","family":"Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Cardiology Department Nuestra Se\u00f1ora de Candelaria University Hospital Canary Islands Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2864-9832","authenticated-orcid":false,"given":"Jorge","family":"Palazuelos\u2010Molinero","sequence":"additional","affiliation":[{"name":"Cardiology Department La Luz University Hospital Madrid 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Position Paper From the ACI\u2010SEC","volume":"5","author":"Jurado\u2010Rom\u00e1n A.","year":"2023","journal-title":"REC: Interventional Cardiology"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.15420\/icr.2019.19.R1"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.29377"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.25270\/jic\/21.00207"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2019.03.036"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.31730","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccd.31730","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.31730","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T05:35:47Z","timestamp":1778996147000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.31730"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,2]]},"references-count":28,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1002\/ccd.31730"],"URL":"https:\/\/doi.org\/10.1002\/ccd.31730","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"value":"1522-1946","type":"print"},{"value":"1522-726X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,2]]},"assertion":[{"value":"2025-06-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}