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Rotational Atherectomy in acute STEMI with heavily calcified culprit lesion is a rule breaking solution The Hybrid Approach to Chronic Total Occlusion Percutaneous Coronary Intervention: Update From the PROGRESS CTO Registry Multicenter Registry of Real-World Patients With Severely Calcified Coronary Lesions Undergoing Orbital Atherectomy: 1-Year Outcomes Chronic Total Occlusion Interventions: Update on Current Tips and Tricks Effect of orbital atherectomy in calcified coronary artery lesions as assessed by optical coherence tomography In-Hospital Outcomes of Chronic Total Occlusion Percutaneous Coronary Interventions in Patients With Prior Coronary Artery Bypass Graft Surgery Procedural Success and Outcomes With Increasing Use of Enabling Strategies for Chronic Total Occlusion Intervention In vivo comparison of lipid-rich plaque on near-infrared spectroscopy with histopathological analysis of coronary atherectomy specimens Orbital atherectomy for the treatment of small (2.5mm) severely calcified coronary lesions: ORBIT II sub-analysis Temporal changes in radial access use, associates and outcomes in patients undergoing PCI using rotational atherectomy between 2007 and 2014: results from the British Cardiovascular Intervention Society national database
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Clinical Case Study2018 May 22. [Epub ahead of print]

JOURNAL：Curr Cardiol Rev. Article Link

Rotational Atherectomy in acute STEMI with heavily calcified culprit lesion is a rule breaking solution

Shahin M. Keywords: Rotational Atherectomy ; STEMI; heavily calcified culprit lesion

ABSTRACT

Calcified coronary lesions represents technical challenges 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 considerded as a contraindication by its manufacturer (Rotablator, Boston Scientific) in a lesion with a visible thrombus. This case demonstrates the successful use of rotational atherectomy to facilitate dilation and revascularization of the culprit lesion in a patient with acute anterior STEMI with ongoing chest pain and heavily calcified culprit lesion.
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