Retrieval of a stuck Rotablator burr ("Kokeshi phenomenon") and successful percutaneous coronary intervention

We report the case of a 74-year-old man having angioplasty following admission with a troponin positive acute coronary syndrome. Due to heavy coronary artery calcification, rotablation was used. The procedure was complicated by a stuck burr ("Kokeshi phenomenon"). We employed a novel method to safely remove the burr and complete the procedure. <Learning objective: Various methods have been described for the retrieval of an entrapped Rotablator burr; we show in this case that deep engagement of guiding catheter and manual traction is a safe and effective method for retrieval.>.