×
It looks like you're using an obsolete version of internet explorer. Internet explorer is no longer supported by Microsoft since the end of 2015. We invite you to use a newer browser such as Firefox, Google Chrome or Microsoft Edge.
29811 views
This didactic procedure concerns a 67 years old male with history of coronary artery disease presenting unstable angina and diffusely calcified and multilevel Right coronary artery lesions.
These lesions were prepared  with rotational atherectomy and  stent implantations were guided by IVUS.

Protocol

  • OptiRAY® (Ioversol)
  • Concentration 350 mgI/ml
  • Flow rate: 8 mL/ s
  • Volume: 228 mL
  • Total exposure : 8.2 Gy
  • Exposure time: 62 minutes
  • 15 images / slow dose Philips

Learning points

  • Lesions selection for Rotational atherectomy.
  • How to prepare  and use the device.
  • Guiding catheter, guidewire  and Burr size selection.
  • How to perform multilevel plaque modification.
  • Guiding catheter extension to improve support and stent delivery.
  • IVUS assessment before and after stenting.

Step-by-Step Procedure

  • Arterial Femoral access 7F, Temporary pace-maker insertion and RCA catheterization with JR4 7F Guiding catheter.
  • Crossing the lesion using Whisper LS coronary PCI guidewire.
  • Exchange the Coronary guidewire with Rotawire Extra support guidewire using a Finecross microcatheter.
  • Rotational atherectomy runs from proximal RCA to the distal bifurcation with 1.5mm Burr.
  • IVUS assessment showing optimal plaque modification.
  • Predilatation with 3.0x20mm balloon and Rotawire exchange to BMW 0.014 guidewire.
  • Stenting of the distal bifurcation with 4.5x18mm Onyx Drug Eluting Stent using Guideliner catheter extension.
  • Stenting of the distal PL with 3.5x12mm Onyx stent for dissection.
  • Stenting of the Mid and Proximal RCA .
  • IVUS control of the final result.

 

Biobliography

Shooting date : 2016-11-18
Last update : 2021-05-11

Focus on Rotablation

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

Share

Our Cases of the Month

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...

Share
7 comments
Join the Discussion
See previous comments (3)
  • Dang D. good result

      Please, select your files, click upload button, write your comment and click the send button. (allowed formats : images jpeg, gif, png, and PDF)
      Your browser doesn't have Flash, Silverlight or HTML5 support.


    • isa S. good

        Please, select your files, click upload button, write your comment and click the send button. (allowed formats : images jpeg, gif, png, and PDF)
        Your browser doesn't have Flash, Silverlight or HTML5 support.


      • Ademaj F. very nice result. Congratilations.

          Please, select your files, click upload button, write your comment and click the send button. (allowed formats : images jpeg, gif, png, and PDF)
          Your browser doesn't have Flash, Silverlight or HTML5 support.


        • mehmet M. good result. congragulationsLeave a new comment to the discussion

            Please, select your files, click upload button, write your comment and click the send button. (allowed formats : images jpeg, gif, png, and PDF)
            Your browser doesn't have Flash, Silverlight or HTML5 support.


          • Anil D. Great results

              Please, select your files, click upload button, write your comment and click the send button. (allowed formats : images jpeg, gif, png, and PDF)
              Your browser doesn't have Flash, Silverlight or HTML5 support.


            • Roberto R. Congratulations

                Please, select your files, click upload button, write your comment and click the send button. (allowed formats : images jpeg, gif, png, and PDF)
                Your browser doesn't have Flash, Silverlight or HTML5 support.


              • Dr. S Vijay Kumar R. excellent demonstration of truely complex case

                  Please, select your files, click upload button, write your comment and click the send button. (allowed formats : images jpeg, gif, png, and PDF)
                  Your browser doesn't have Flash, Silverlight or HTML5 support.


                Suggestions

                May 2017
                Honolulu : Tuesday, May 16th 2017 from 10:30pm to 11:30pm (GMT-10)
                San Francisco : Wednesday, May 17th 2017 from 01:30am to 02:30am (GMT-7)
                New York : Wednesday, May 17th 2017 from 04:30am to 05:30am (GMT-4)
                Buenos Aires : Wednesday, May 17th 2017 from 05:30am to 06:30am (GMT-3)
                Reykjavik : Wednesday, May 17th 2017 from 08:30am to 09:30am (GMT)
                London / Dublin : Wednesday, May 17th 2017 from 09:30am to 10:30am (GMT+1)
                Paris / Berlin : Wednesday, May 17th 2017 from 10:30am to 11:30am (GMT+2)
                Istanbul : Wednesday, May 17th 2017 from 11:30am to 12:30pm (GMT+3)
                Moscou / Dubaï : Wednesday, May 17th 2017 from 12:30pm to 01:30pm (GMT+4)
                Bangkok : Wednesday, May 17th 2017 from 03:30pm to 04:30pm (GMT+7)
                Shanghai : Wednesday, May 17th 2017 from 04:30pm to 05:30pm (GMT+8)
                Tokyo : Wednesday, May 17th 2017 from 05:30pm to 06:30pm (GMT+9)
                Sydney : Wednesday, May 17th 2017 from 07:30pm to 08:30pm (GMT+11)
                Wellington : Wednesday, May 17th 2017 from 09:30pm to 10:30pm (GMT+13)

                Discussion around complex PCI

                How to deal with complications?

                Share

                Recanalization for limb salvage

                Three occlusions: femoral, popliteal and posterior tibial arteries - Case of the month: December 201...

                Share
                Scroll Up