A Rotational atherectomy: short lesion - big problem
Date |
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2022-05-17 |
no. Euro22C-OP264
Klaida: Ramunas U.
History of presentation. 64 year-old male. Admitted with inferior STEMI. Moderately impaired LVEF. Past Medical History: Coronary artery disease, acute MI followed by PCI to a right coronary artery in 2013. Arterial Hypertension. Dyslipidaemia. Active smoker. Investigations. A transthoracic echocardiogram revealed moderately impaired LVEF (40%), impaired left ventricle relaxation, hypokinetic inferior and lateral walls. Diagnostic angiogram demonstrated acute occlusion of right coronary artery and a focal calcific lesion in left circumflex artery. A successful primary PCI of right coronary artery performed. As the focal lesion in the left circumflex artery appeared to be severely calcified, the patient was referred for a staged rotational atherectomy and PCI. A coronary microcatheter (Boston Scientific MAMBA 135) failed to cross the lesion. The lesion wired with rotablator wire (Rotawire Floppy) alone. 1,5 mm RotaPro burr selected for the procedure. The lesion was short and focal, it was thought to be a very straight forward rotablation case even suitable to teach a trainee... [...].