High-frequency rotablation of occluded coronary artery during heart catheterization

High-frequency rotation atherectomy of an occluded left circumflex coronary artery was performed in a 45-year-old man. Over a 0.009 inch flexible tip steel wire a diamond-coated brass burr fastened to a flexible drive shaft that rotates and tracks was advanced. The drive shaft was connected to a turbine and driven by compressed air with 150,000 rpm. After rotablation of the posterior lateral branch over 3 cm with a 1.5 mm burr and rotablation with a 1.75 mm burr of the posterior branch of the left circumflex coronary artery the vessel was reopened with a smooth surface without perforation and dissection. 24 h control and 6 mo control revealed an open coronary vessel. High frequency rotating coronary angioplasty seems to be a promising alternative method to PTCA in opening totally occluded coronary arteries.