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Trapped Rotablator: kokesi phenomenon

H Kaneda1, S Saito, G Hosokawa

  • 1Department of Cardiology, Shonan Kamakura General Hospital, Kanagawa, Japan. hdkaneda-tky@umin.ac.jp

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|January 8, 2000
PubMed

Insights

Rotational atherectomy can rarely cause complications when the device gets stuck in calcified blockages. Successful retrieval required surgical resection of major arteries.

Area of Science:

  • Interventional Cardiology
  • Cardiovascular Surgery

Background:

  • Rotational atherectomy is a common procedure for treating calcified coronary artery lesions.
  • Ensuring device retrieval is critical for patient safety during interventional procedures.

Observation:

  • A rare complication occurred during rotational atherectomy where the device burr became entrapped.
  • The entrapment happened at a sharply angled and heavily calcified stenosis in the left anterior descending coronary artery.

Findings:

  • The trapped burr necessitated an emergent surgical intervention.
  • Successful retrieval involved resection of both the pulmonary artery and the left coronary artery.

Implications:

  • This case highlights a severe, uncommon complication of rotational atherectomy.
  • Understanding the causes and implementing preventive strategies are crucial for interventional cardiologists.

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