![]() Well as diffusely calcified stenosis in mid Right Coronary Artery Initial coronary angiography showed chronic total occlusion in the proximal LeftĪnterior Descending artery (LAD) In-Stent Restenosis (ISR), as (CHF) and Cerebrovascular Accident (CVA). Of previous Myocardial Infarction (MI), Chronic Heart Failure Mellitus (DM) and hypertension, and had past medical history The patient’s coronary risk factors were Diabetes The patient’s symptoms remained as before and considered CABG if necessary.Ī 54-year-old man was admitted to our hospital with unstable angina. SPECT showed severe myocardial infarction in LAD territory and severe LV systolic dysfunction with global hypokinesia. Percutaneous coronary intervention was performed. Echocardiogram showed LVEF was 30-34% and suggested ischeamic heart disease with moderate to severe LV dysfunction, moderate LVE, mild LAE with elevate LV filling pressure. MDCT showed diffuse dense calcification and luminal narrowing at pLAD (previous inserted stent), markedly decreased ejection fraction of left ventricle with dilatation OMà Directional coronary atherectomy 3.0-3.4 Successful retrieval of a stuck rotablator burr and PTCA balloon by using a guideliner catheter at complex LAD lesion: A case report. Keywords: Coronary artery disease Chronic total occlusion Rotational atherectomy Burr entrapment Guideliner. Nearly detached from the rota wire during retraction.ĭiscussion: We might get an information of the degree of fibrousĪnd angulated calcification by MDCT before PCI and this will be helpful Remaining system and fixed the catheter tip near the entrapped rotablator burr by pushing and pulling the rotablator at the same time.įinally the rota system was removed successfully, but the burr was Sheath of the rota, inserted a 5.5 Fr Guideliner catheter through the We performed a gentle manual retraction of the rota and attempted to insert another guidewire to alongside the burr for balloonĭilation to free the burr, but wiring failed. The burr suddenly became trapped within the calcified lesion at the distal angulated edge. Severe angulated calcified lesion at the proximal LAD, the 1.0 balloonĬould not pass the lesion, so we performed rotablation. ![]() Was inserted into distal LAD using Guideliner catheter. A Runthrough was inserted into D1, and the XTR guidewire ![]() The left coronary ostium was engaged withħFr EBU. Therefore, a less invasive measure isĬase summary: A 54-year-old man with Diabetes Mellitus (DM)Īnd hypertension revealed chronic total occlusion in the proximal LAD Background: An entrapped rotablator burr is a rare but severeĬomplication of Rotational Atherectomy (RA), and surgical removal is
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