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The Hybrid Approach to Chronic Total Occlusion Percutaneous Coronary Intervention: Update From the PROGRESS CTO Registry State of the art: evolving concepts in the treatment of heavily calcified and undilatable coronary stenoses - from debulking to plaque modification, a 40-year-long journey Long-term clinical outcomes of permanent polymer everolimus-eluting stent implantation following rotational atherectomy for severely calcified de novo coronary lesions: Results of a 22-center study (Tokyo-MD PCI Study) Clinical Characteristics and Long-Term Outcomes of Rotational Atherectomy-J2T Multicenter Registry One-Year Outcomes of Orbital Atherectomy of Long, Diffusely Calcified Coronary Artery Lesions Orbital atherectomy for the treatment of small (2.5mm) severely calcified coronary lesions: ORBIT II sub-analysis Orbital atherectomy for treating de novo, severely calcified coronary lesions: 3-year results of the pivotal ORBIT II trial Pivotal trial to evaluate the safety and efficacy of the orbital atherectomy system in treating de novo, severely calcified coronary lesions (ORBIT II) Outcomes After Orbital Atherectomy of Severely Calcified Left Main Lesions: Analysis of the ORBIT II Study Multicenter Registry of Real-World Patients With Severely Calcified Coronary Lesions Undergoing Orbital Atherectomy: 1-Year Outcomes
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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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