Rotational Atherectomy in Acute STEMI with Heavily Calcified Culprit Lesion is a Rule Breaking Solution.
- Shahin M Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland.
- Candreva A Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland.
- Siegrist PT Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland.
- 2018-05-24
Published in:
- Current cardiology reviews. - 2018
Rotational atherectomy
STEMI
TLR
calcified culprit lesion
chest pain
thrombus.
Aged
Atherectomy, Coronary
Humans
Male
ST Elevation Myocardial Infarction
Treatment Outcome
English
BACKGROUND
Calcified coronary lesions represent technical challenges during percutaneous coronary intervention 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 considered a contraindication in lesions with a visible thrombus by its manufacturer (Rotablator, Boston Scientific).
CONCLUSION
This case demonstrates the successful use of rotational atherectomy to facilitate dilation and revascularization of a heavily calcified culprit lesions in a patient with acute anterior STEMI with ongoing chest pain.
Calcified coronary lesions represent technical challenges during percutaneous coronary intervention 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 considered a contraindication in lesions with a visible thrombus by its manufacturer (Rotablator, Boston Scientific).
CONCLUSION
This case demonstrates the successful use of rotational atherectomy to facilitate dilation and revascularization of a heavily calcified culprit lesions in a patient with acute anterior STEMI with ongoing chest pain.
- Language
-
- English
- Open access status
- green
- Identifiers
-
- DOI 10.2174/1573403X14666180523084846
- PMID 29788894
- Persistent URL
- https://folia.unifr.ch/global/documents/128564
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