Aim Componing the acute efficacy and safety of percutaneous transluminal coronary angioplasty (PTCA) and percutaneous transluminal coronary rotational ablation (PTCRA) patients with coronary heart diseaseMethods Success rates, residual stenosis, and incidences of complications in both PTCA and PTCRAgroups were compared.Results The diameter stenosis was reduced from 80%±14% to 20%±10% using PTCA for 46 lesions in 40 patients, and reduced from 84%±9% to 29%±2% using PTCRA for 17 lesions in 10 patients. The residual stenosis significantly differed from each other (p<0.05). The success rates were 82.5% and 80%, respectively of PTCA and PTCRA (p>0.05). The overall incidences of complications were 17.5% and 80%, respectively for PTCA and PTCRA (p<0.001), with the incidences of major complications of respectively 2.5% and 5% (p<0.001). No death occurred in PTCA, while one patient died in PTCRA during the procedure.Conclusion Success rate, efficacy and safety in PTCA was superior to in PTCRA. Furthermore,PTCA has widespread indications. PTCRA is suitable merely to some "hard" lesions or some lesions anatomically unsuitable to PTCA. Adjunctive PTCA is necessary to improve PTCRA efficacy when residual stenosis is remarkable.