Switching Rotablator Burr from 1.25 mm to 1.5 mm for an Uncrossable, Calcified and Angulated Left Anterior Descending Lesion

Cheng-Chun Wei ； Shih-Huang Lee

《Journal of Taiwan Society of Cardiovascular Interventions》 14卷1期 (2023/01) Pp. 30-34

摘要

We describe a case of a hemodialysis patient who presented with acute coronary syndrome. The culprit lesion mainly involved the left anterior descending artery. Rotablation was imperative to debulk and crack the calcified plaque inside the vessel wall. However, the vessel was highly angulated, making the procedure quite difficult and risky. The operator adopted a counterintuitive strategy, to size up the burr from 1.25 mm to 1.5 mm and successfully crossed the angulated lesion without complications. We discuss possible mechanisms, based on the structural difference between the 1.25 mm and 1.5 mm burrs.

關鍵字

rotational atherectomy ； burr size