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Background To evaluate the efficacy of tranradial rotational atherectomy (RA) followed by drug eluting stent (DES) implantation in treating patients with complex coronary calcified lesions under the guidance of intravascular ultrasound.Methods Demographic characteristics,coronary angiogram,intravascular ultrasound images,peri-procedure and follow-up data from 44 patients treated with RA and DES implantation were retrospectively analyzed.