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Background: Several recent reports have shown that a stentless interventional procedure using rotational atherectomy followed by drug-coated balloon (DCB) treatment (RA/DCB) is a potent revascularization therapy for calcified de novo lesions even in the newgeneration drug-eluting stent era; however, the role of the RA/DCB procedure for noncalcified de novo lesions remains unclear. Methods: A total of 47 consecutive patients (53 lesions) who underwent RA/DCB for coronary de novo lesions were enrolled. According to the presence or absence of severe calcification at target lesions on fluoroscopy, the 47 patients were divided into the noncalcified cases (n ¼ 12) and the calcified cases (n ¼ 35), and the 53 lesions were R ESUM E Contexte : Plusieurs rapports r ecents ont montr e qu'une revascularisation sans endoprothèse effectu ee par ath erectomie rotationnelle (AR) suivie d'un traitement par ballonnet m edicament e (BM) constitue une m ethode efficace pour traiter les nouvelles l esions calcifi ees, même à l'ère des endoprothèses m edicament ees de nouvelle g en eration; on ne connaît toutefois pas bien l'utilit e de l'intervention par AR et BM en cas de nouvelles l esions non calcifi ees. M ethodologie : Au total, 47 patients cons ecutifs (53 l esions) ayant subi une intervention par AR et BM pour traiter de nouvelles l esions coronariennes ont et e admis dans l' etude. Ces 47 patients ont et e r epartis en deux groupes, en fonction de l'absence (n ¼ 12) ou de laDrug-eluting stent (DES) implantation has been a standard interventional treatment of coronary artery disease (CAD); however, there still remain several DES-unfavourable clinical or lesion backgrounds, such as bleeding tendency, intolerance to antiplatelet agents, metal allergy, severe or diffuse calcified lesions, calcified nodules, and ostial or bifurcation lesions. For CAD patients complicated with these specific conditions, percutaneous coronary intervention (PCI) without stent implantation "stentless PCI" is theoretically a promising revascularization therapy. Recently drug-coated balloon (DCB)-only angioplasty for de novo lesions has attracted greater attention, and pretreatment with rotational atherectomy (RA) followed by DCB treatment (RA/DCB) has been reported to be an option of stentless PCI particularly for calcified de novo lesions. [1][2][3][4] However, even small-sized data regarding the RA/ DCB procedure for noncalcified de novo lesions are still lacking. The purpose of the present retrospective study was therefore to compare angiographic results and clinical outcomes in patients with noncalcified de novo lesions who underwent RA/ DCB with patients with calcified de novo lesions in a real-world clinical practice. Methods Patient population and procedureFrom December 2014 to September 2019, 47 consecutive patients (53 lesions) who eventually underwent stentless PCI using RA/DCB for coronary de novo lesions or restenotic lesions after balloon angioplasty in our hospital were retrospectively enrolled. Lesions requiring bailout stenting and in-s...