Background: Calcified coronary lesions represent technical challenges during percutaneous coronary intervention and are associated with a high frequency of restenosis and target lesion revascularization. Rotational atherectomy has been shown to increase procedural success in severely calcified lesions, facilitate stent delivery in undilatable lesions and ensure complete stent expansion. However, rotational atherectomy in ST-elevation Myocardial Infarction (STEMI) is traditionally avoided given the concern for slow or no reflow and considered a contraindication in lesions with a visible thrombus by its manufacturer (Rotablator, Boston Scientific).
Conclusion: This case demonstrates the successful use of rotational atherectomy to facilitate dilation and revascularization of a heavily calcified culprit lesions in a patient with acute anterior STEMI with ongoing chest pain.
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http://dx.doi.org/10.2174/1573403X14666180523084846 | DOI Listing |
Catheter Cardiovasc Interv
January 2025
Lancashire Cardiac Centre, Blackpool, UK.
Coronary calcification is a major factor leading to stent under-expansion, and subsequent adverse events. This meta-analysis aimed to evaluate the short and long‑term outcomes of rotational atherectomy (RA), followed by modified balloon (cutting or scoring) (MB) versus plain balloon before drug‑eluting stent implantation for calcified coronary lesions. We searched PubMed, Web of Science (WOS), Scopus, and the Cochrane Library Central Register of Controlled Trials (CENTRAL), from inception until 30 January 2024.
View Article and Find Full Text PDFRev Cardiovasc Med
December 2024
Department of Cardiology, Bern University Hospital, Inselspital, CH-3010 Bern, Switzerland.
In-stent restenosis (ISR) remains the predominant cause of stent failure and the most common indication for repeat revascularization. Despite technological advances in stent design, ISR continues to pose significant challenges, contributing to increased morbidity and mortality among patients undergoing percutaneous coronary interventions. In the last decade, intravascular imaging has emerged as an important method for identifying the mechanisms behind ISR and guiding its treatment.
View Article and Find Full Text PDFJ Int Med Res
December 2024
Department of Cardiology, General Hospital of Ningxia Medical University, Yinchuan, People's Republic of China.
Objective: This study aimed to compare the efficacy and safety of intravascular ultrasound (IVUS)-guided coronary intravascular lithotripsy and rotational atherectomy in treating severe coronary artery calcification.
Methods: A retrospective analysis of 60 patients who underwent percutaneous coronary intervention at the General Hospital of Ningxia Medical University from October 2022 to August 2023 was conducted. The patients were divided into two groups: 30 received IVUS-guided coronary intravascular lithotripsy and 30 underwent IVUS-guided rotational atherectomy.
J Cardiothorac Surg
December 2024
Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, No. 45, Changchun Street, Beijing, 100053, China.
Objective: This study aimed to analyze the safety and mid-term outcomes of a hybrid treatment method combining rotational atherectomy (RA) with drug-coated balloon (DCB) angioplasty in patients with femoropopliteal artery in-stent restenosis (ISR).
Methods: This single-center retrospective study enrolled patients from January 2018 to March 2022 who had femoropopliteal artery in-stent restenosis treated by RA and DCB. Preoperative demographics, operative details, and postoperative 12-month follow-up outcomes were analyzed statistically.
J Cardiol Cases
December 2024
Department of Cardiology, Kyoto Saiseikai Hospital, Nagaokakyo, Japan.
Unlabelled: Intervention to proximal lesions should be avoided in graft-protected native coronary arteries in general, because there might be a risk for bypass-graft failure. An 81-year-old man with coronary artery bypass grafting surgery due to 3-vessel disease 17 years previously complained of worsening angina. Coronary angiography (CAG) revealed a diseased saphenous vein graft (SVG) and a probable functional occlusion in the mid left anterior descending coronary artery (LAD) concomitant with calcified severe stenosis in the left main (LM)-proximal LAD, and patent right internal thoracic artery (RITA)-LAD graft.
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