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Background To compare the safty and efficacy between low-speed and high-speed coronary rotational atherectomy for the treatment of heavily calcified lesions.Methods From January 2008 to September 2012, 107consecutive patients with heavily calcified lesions who underwent rotational atherectomy in our hospital were enrolled in this retrospective study.Patients were divided according to rotational speed into two groups: low-speed rotational atherectomy (LSRA)(speed ≤160 000 r/min) and high-speed rotational atherectomy (HSRA) (speed > 160 000 r/min).We compared the success rates of RA and stenting,rates of complication during perioperations, MACE during hospitalization and after one year follow up.