OBJECTIVES: Coronary artery disease (CAD), a leading cause of death worldwide, disproportionately affects individuals aged 65 and older. Rotational atherectomy (RA) treats CAD by using a high-speed drill to remove calcified plaques and expand arteries, often in conjunction with stent placement. This method is particularly effective for high-risk or resistant calcified lesions. The study aims to evaluate the penetration and effectiveness of RA therapy in Türkiye, focusing on CAD. Additionally, it explores the safety and efficacy of this treatment approach.

METHODS: A mixed-method approach was utilized for this study. Initially, an e-survey consisting of 16 questions was administered to 62 physicians from May 12, 2023, to January 18, 2024. Subsequently, a semi-structured focus group discussion involving 10 experts was conducted to interpret the key findings of the survey within the framework of Turkish clinical practice.

RESULTS: Survey data from Türkiye as of 2024 show a significant increase in percutaneous coronary interventions, with 94% of physicians observing an upward trend. RA, preferred for its effectiveness and coverage by reimbursement policies, is primarily employed in university hospitals for modifying calcified lesions. The effectiveness of RA is demonstrated by its high success rate in 94% of cases. Additionally, it is associated with a lower rate of cardiovascular death—the most severe complication—recorded at 0.8%, compared to 1.1% for balloon atherectomy and intracoronary lithotripsy.

CONCLUSIONS: RA has emerged as a vital technique for treating complex coronary lesions in Türkiye, significantly enhancing clinical outcomes. The favorable results underscore the need for broader adoption and integration of RA into standard treatment protocols. To achieve this, concerted efforts are necessary to increase awareness and interest among key stakeholders, including payers and physicians. Initiatives aimed at educating healthcare providers and aligning reimbursement policies to support RA use are crucial for expanding access and optimizing patient outcomes.