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WASHINGTON -- An atherectomy device with a precision diamond tip that "sands" away calcified plaque may guarantee success in coronary lesions that often defeat traditional stenting approaches.

Early results from COAST, a trial of the Coronary Orbital Atherectomy System (OAS) Micro Crown suggest the device can reduce 30 day adverse events rates, , of St. Francis Hospital in Roslyn, N.Y., reported here at CRT 2016.

Micro Crown -- an atherectomy system that provides bidirectional sanding and permits constant flow during atherectomy -- was associated with 30-day rates of 14.0% for MI, 1.0% for target vessel revascularization, and 1.0% for cardiac death, Shlofmitz said.

These events occurred early on, with the incidence of in-hospital myocardial infarction at 13.0%, cardiac death at 1.0%, and target vessel revascularization not reported.

Furthermore, the Micro Crown was successfully delivered 99.0% of the time, defined as leaving less than 50% residual stenosis.

Thus, for the "historically difficult-to-treat" population with severely calcified plaque -- as calcification may prevent adequate stent expansion or preclude stent delivery -- "OAS is a technology that may address an unmet treatment need," he said. His abstract was one of three selected for their practice changing potential.

The prospective COAST study included 100 patients with severely calcified lesions as demonstrated by angiogram, intravascular ultrasound, or optical coherence tomography.

During sanding, complications such as perforation (2.0%), slow flow or no re-flow (2.0%), and abrupt closure (3.0%) occurred.

When session moderator , of Germany's Heart Center Siegburg, asked what might have caused the lack of distal embolization no-flow, Shlofmitz suggested the advantages of continuous arterial flow and 20-second maximum bursts of sanding.

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