Coronary Angioplasty and Rotational Atherectomy Trial - CARAT


Aggressive vs conservative rotablator strategies in native coronary arteries.


To compare the early and late clinical and angiographic outcomes after conservative vs. aggressive atherectomy.

Study Design

Study Design:

Patients Screened: Not given
Patients Enrolled: 222
Mean Follow Up: 6 months

Patient Populations:

Native coronary lesions
Vessel size 2.0-3.5 mm

Primary Endpoints:

Final diameter stenosis at end of procedure

Secondary Endpoints:

Angiographic complications (side branch occlusion, no-reflow, severe dissection).
Target lesion revascularization at 6 months.

Drug/Procedures Used:

Conservative (burr:artery ratio < 0.7) versus aggressive (burr:artery ratio ≥ 0.7) rotational atherectomy strategies

Principal Findings:

A total of 104 patients (118 lesions) were randomized to the aggressive arm, and 118 patients (136 lesions) to the conservative arm.

Angiographic complication rates were 16.4% for patients in the aggressive arm compared to 8.2% in the conservative arm (p < 0.05).

Target lesion revascularization rates were 21% in the aggressive arm compared to 21.7% in the conservative arm.


A routine strategy using small burrs achieves similar immediate lumen enlargement and late target lesion revascularization compared to large burrs, but with fewer angiographic complications.


1. J Am Coll Cardiol 1998;31(Abstr Suppl):378A. Preliminary results

Clinical Topics: Cardiac Surgery, Invasive Cardiovascular Angiography and Intervention, Atherosclerotic Disease (CAD/PAD), Aortic Surgery, Interventions and Coronary Artery Disease

Keywords: Coronary Artery Disease, Atherectomy, Coronary

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