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The effects of orbital atherectomy (OA) and its impact on calcified coronary plaques are not yet fully understood, highlighting the need for a\u00a0larger and more comprehensive study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Calcium Reduction by Orbital Atherectomy in Western Europe (CROWN) is an ongoing study that aims to evaluate the effects of OA in treating de novo, severely calcified coronary lesions before stent placement using optical coherence tomography (OCT), and to assess stent expansion by measuring the OCT-derived minimum stent area (MSA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The CROWN study is a\u00a0prospective, multicenter, international, single-arm observational study. We will enroll 100 patients with severely calcified coronary lesions undergoing OCT-guided orbital atherectomy and stent placement. All patients will undergo peri-procedural OCT imaging, with assessments conducted before and after OA, as well as following stent placement. Patients will be enrolled at a maximum of 6\u00a0sites in the Netherlands, Germany, and Italy. The primary endpoint is to assess the proportion of patients achieving stent expansion, defined as an OCT-derived MSA \u2265\u202f5.5\u202fmm\n                      <jats:sup>2<\/jats:sup>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The CROWN study will evaluate the impact of OA on calcified plaques, potentially refine operator practices, and provide additional insights on device selection for treating severely calcified lesions (clinicaltrials.gov NCT06035783).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12471-026-02055-5","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T07:19:59Z","timestamp":1785827999000},"page":"299-305","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Optical coherence tomography-guided orbital atherectomy for calcified coronary lesions: rationale and design of the CROWN study"],"prefix":"10.1007","volume":"34","author":[{"given":"Eleni","family":"Ntantou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandros A.","family":"Siskos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas M.","family":"van Mieghem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joost","family":"Daemen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Kardys","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koen","family":"Teeuwen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gioel G.","family":"Secco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan-Malte","family":"Sinning","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Forlani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wijnand K.","family":"den Dekker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"key":"2055_CR1","doi-asserted-by":"publisher","first-page":"1845","DOI":"10.1016\/j.jacc.2014.01.034","volume":"63","author":"P G\u00e9n\u00e9reux","year":"2014","unstructured":"G\u00e9n\u00e9reux\u00a0P, Madhavan\u00a0MV, Mintz\u00a0GS, et\u00a0al. 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J.\u00a0Daemen received institutional grant\/research support from Abbott Vascular, Boston Scientific, ACIST Medical, Medtronic, Pie Medical, and ReCor medical, and consultancy and speaker fees from Abbott Vascular, ACIST medical, Boston Scientific, Cardialysis BV, CardiacBooster, Kaminari Medical, ReCor Medical, Pie Medical, Sanofi, Siemens Health Care and Medtronic. K.\u00a0Teeuwen received a\u00a0speaker\u2019s fee sponsored by Abbott. J.-M.\u00a0Sinning is proctor for Medtronic and Boston Scientific and is a\u00a0member of scientific advisory boards of Abbott, Abiomed, Boston Scientific, Boehringer Ingelheim, and Medtronic and receives speaker honoraria and\/or travel expenses from Abbott, Abiomed, Astra Zeneca, Bayer, Boehringer Ingelheim, Boston Scientific, Bristol Myers Squibb, Edwards Lifesciences, Medtronic, Novartis, Novo Nordisk, Pfizer, Shockwave Medical, and Zoll. W.K.\u00a0den Dekker received an institutional grant from Abbott\u00a0and Biotronik\u00a0and consulting and speaker\u00a0fees from Xylocor and Vesalio. E.\u00a0Ntantou, A.A.\u00a0Siskos, I.\u00a0Kardys, G.G.\u00a0Secco and D.\u00a0Forlani declare that they have no competing interests.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}