TCT 2025 —  Dr Suzanne J Baron (Massachusetts General Hospital, US), principal investigator of the Short-CUT trial (NCT06089135; Baim Institute for Clinical Research), joins us to discuss this investigator-initiated, multicentre randomized controlled study.

The trial enrolled 410 patients with moderate to severe coronary artery calcification across up to 22 international sites. Eligible participants had de novo coronary lesions in vessels measuring 2.5–4.0 mm in diameter, with at least 50% stenosis and angiographic or intravascular evidence of calcification. Patients were assigned to one of two cohorts. The rotational atherectomy cohort included those requiring upfront atherectomy, who were randomized to Cutting Balloon angioplasty or intravascular lithotripsy (IVL) following atherectomy. The non-atherectomy cohort included patients in whom atherectomy was not planned, randomized after successful wire crossing.

The primary endpoint was the minimum stent area at the site of greatest calcification, assessed by OCT or IVUS, using a non-inferiority design. Secondary endpoints included procedural success, stent expansion, peri-procedural myocardial infarction, device-related complications, and major adverse cardiac events (MACE) at 12 months.

Investigators found no differences between IVL and balloon angioplasty in stent expansion, presence of calcium fractures, strategy success, intraprocedural adverse events or MACCE at 30 days. Procedural cost of IVL was significantly higher, suggesting cutting balloon angioplasty could be a less costly option for patients with calcified lesions.

Interview Questions:
1. What is the importance of this trial?
2. What is the study design and the endpoints?
3. What are the key results presented at TCT 25?
4. What are the take-home messages for practice?
5. What are the next steps?

For more content from TCT 2025 head to the Late-breaking Science Video Collection.

Interviewer: Liam O'Neill
Editors: Jordan Rance & Mirjam Boros

Videographers: Tom Green & Mike Knight

Recorded on-site at TCT 2025, October.

Support: This is an independent interview produced by Radcliffe Cardiology.