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This 20-minute case concerns an 83-year-old man with stable angina, good LV function, and permanent atrial fibrillation on long-term anticoagulation. 
This patient was first treated with a 1.75 millimeter burr on the RCA followed by DES.

Step-by-Step Procedure

  • Description of the challenge of the day 
  • Placement of the Rotawire 
  • Rotablation technique and rotablation cocktail 
  • Rotablation of left main and left descending artery 
  • Post dilatation and post IVUS evaluation 
  • LAD and left main stenting, IVUS evaluation 

Learning points

  • The use of the Rotablator on RCA 
  • The placement of the Rotablator guidewire using a micro-catheter to exchange GW
  • The Rotablation cocktail and the Rotablation technique
  • IVUS evaluation after Burr debulking

Bibliography

Shooting date : 2016-12-15
Last update : 2021-05-11
Peter O'Kane, Md
Bournemouth, United Kingdom
Jehangir Din, Md
Bournemouth, United Kingdom
Sami Omar, Md
Bournemouth, United Kingdom

Focus on Rotablation

Learn more about Rotational Atherectomy System for plaque modification in complex patients with heavily calcified lesions.

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The case of the month is a new way for our users to watch, learn, and share with incathlab. They can watch a video that highlights an innovative case and uses excellent pedagogical techniques, lear...

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  • Alexander P. The best!

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    • Mohamed sabry M. what about the mid segment of LAD? i think it is significant calcific and stenosed.

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      • Mohamed sabry M. very good..

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        • islam O. Can rotablator be used in case of ISR or contraindicated,when to start with ballon preparation befor shift to rotablator

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          • Max A. Rotablator have been used in case of ISR , but has an extremely limited role for several reasons.
            Rotablator could be used carefully after balloon dilatation in case of undilatable lesion.

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            • narayana reddy B. Good result

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              • Babu E. Whether floppy or extra support rota wire used in this case for LAD?

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                • Babu E. What was the size of burr used in LAD? How to choose among 2.25mm , 2.5mm or 2.75mm burrs for a given vessel with lesion?

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                  • bajarang B. want to see the full picture sir

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                    • venkatesa reddy D. very well explained use of rota

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