Transradial left main stem rotational artherectomy and stenting: case report and literature review

Area of Science:

• Interventional Cardiology
• Vascular Interventions
• Complex Coronary Artery Disease

Background:

• Percutaneous coronary interventions (PCI) for complex unprotected left main stem (LMS) lesions, especially with rotational atherectomy, present significant technical challenges and risks.
• The radial approach for these complex LMS PCI cases is less established, with limited reported experience.

Observation:

• A case involving an unstable patient with severe distal LMS disease is presented.
• The patient had contraindications for traditional treatments, including cardiac surgery, intra-aortic balloon pumping, and the femoral approach.

Findings:

• Successful treatment of severe distal LMS disease was achieved using a radial approach for PCI.
• The procedure involved rotational atherectomy, demonstrating its applicability in complex radial interventions.

Implications:

• This case suggests that a radial approach can be a viable and successful option for complex unprotected LMS PCI in high-risk patients when other options are contraindicated.
• Further investigation into the technical aspects and outcomes of radial approach for complex LMS PCI is warranted.