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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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