Evaluation of Treatment Strategies for Severe CaLcIfic Coronary Arteries: Orbital Atherectomy vs. Conventional Angioplasty Technique Prior to Implantation of Drug- Eluting StEnts: The ECLIPSE Trial . The Device is The Diamondback 360® Coronary Orbital Atherectomy System (OAS) 1.25mm classic crown.

General Inclusion Criteria:

1. Subject is 18 years of age or older.
2. Subject presents with:

• stable ischemic heart disease or
• acute coronary syndrome (NSTEMI or unstable angina), or
• stabilized recent STEMI (>48 hours prior to randomization procedure)

3. Subject has signed the Institutional Review Board (IRB) approved ECLIPSE trial Informed Consent Form (ICF) prior to any trial related procedures.

General Exclustion Criteria:

1. Subject has a history of any cognitive or mental health status that would interfere with trial participation.
2. Subject is participating in or has plans to participate in any other investigational drug or device trial that has not reached its primary endpoint.
3. Subject is a female who is pregnant.
4. Subject is receiving or scheduled to receive chemotherapy within thirty (30) days prior or any time after the randomization procedure.
5. Subject has a life expectancy of ≤ 12 months.
6. Subject has undergone any prior PCI in the target vessel or its branches within 12 months prior to randomization.
7. Subject has undergone a PCI procedure that is unsuccessful or with complications within 30 days prior to randomization, including during the randomization procedure.
8. Any cardiac intervention or surgery planned within 12 months post randomization procedure aside from a potential planned staged PCI as part of the randomized treatment strategy (see planned staged procedure section).
9. Subject has major valve disease and underwent intervention within 30 days prior to randomization.
10. Subject has received a heart transplant.
11. Evidence of heart failure by at least one of the following (note - Left Ventricular Ejection Fraction [LVEF] is not required by protocol):

• Most recent LVEF ≤25%, or
• Current heart failure defined as NYHA class ≥3 (all patients) or Killip class ≥2 (post STEMI patients)

12. Planned use in the randomized lesion(s) of a bare metal stent (BMS), bioresorbable scaffold (BRS), or non-stent treatment only.
13. Subject has a known sensitivity to contrast media, which cannot be adequately premedicated.
14. Subject has a relative or absolute contraindication to aspirin or all P2Y12 inhibitor agents, or will be unable to take both aspirin and a P2Y12 inhibitor for at least 6 months after PCI (e.g., due to a planned surgical procedure).
15. Subject has a history of a stroke or transient ischemic attack (TIA) within six (6) months, or any permanent neurologic deficit.
16. Subject has a history of bleeding diathesis or coagulopathy or intention to refuse blood transfusion if one should become necessary.
17. Subject has evidence of an active infection on the day of the randomization procedure requiring oral or intravenous antibiotics.
18. Subject is not an acceptable candidate for emergent coronary artery bypass graft (CABG).
19. Subject with known allergy to atherectomy lubricant components including soybean oil, egg yolk phospholipids, glycerin and sodium hydroxide.