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Trapping Balloon Technique for Removal of the Burr in Rotational Atherectomy
Kei Yamamoto1, Kenichi Sakakura1, Yousuke Taniguchi1
1Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University.
Insights
Rotational atherectomy (RA) complications like burr entrapment require specific bailout techniques. A novel KUSABI trapping balloon method offers a more reliable way for interventional cardiologists to remove the atherectomy burr.
Area of Science:
- Interventional Cardiology
- Cardiovascular Surgery
Background:
- Rotational atherectomy (RA) is used to treat complex coronary artery disease.
- RA carries unique risks, including burr entrapment and vessel perforation, necessitating effective bailout strategies.
- Maintaining guidewire position during burr removal is challenging due to long guidewires and procedural complexity.
Observation:
- A case study involving an 83-year-old male with stable angina undergoing RA of the left anterior descending artery is presented.
- The KUSABI trapping balloon technique was employed for burr removal.
- The procedure was successfully completed without activating dynaglide mode.
Findings:
- The KUSABI trapping balloon technique provides a reliable method for removing rotational atherectomy burrs.
- This technique simplifies the bailout process, enhancing operator confidence.
- Successful burr removal was achieved, avoiding potential complications.
Implications:
- This technique can improve the safety and efficacy of rotational atherectomy procedures.
- Interventional cardiologists can benefit from adopting this simpler, more reliable burr removal strategy.
- Enhanced familiarity with bailout procedures can lead to better patient outcomes in complex coronary interventions.
Abstract:
Because rotational atherectomy (RA) has several unique complications, such as burr entrapment, vessel perforation, and slow flow, it is important for interventional cardiologists to be familiar with bailout procedures for such complications. The principal part of bailout procedures is to keep a guidewire in the target coronary artery during the procedure. However, it is not easy to keep a guidewire in the same position during the removal of a burr because the length of the RA guidewires is 300 cm, and the removal of a burr requires collaboration between the primary operator and an assistant. We describe the case of an 83-year-old male with stable angina. We performed RA to the left anterior descending artery, and removed the burr using a KUSABI (Kaneka Medix Corporation, OSAKA, Japan) trapping balloon technique without activating the dynaglide mode. This simple technique would help RA operators remove a burr more reliably than the conventional removal technique.
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