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Rotatripsy: synergistic effects of complementary technologies: a case report.
Navjyot Kaur1, C R Pruthvi1, Yashpaul Sharma1
1Department of Cardiology, PGIMER, Chandigarh 160012, India For the podcast associated with this article, please visit https://academic.oup.com/ehjcr/pages/podcast.
European Heart Journal. Case Reports
|June 14, 2021
Summary
Intravascular lithotripsy (IVL) combined with rotablation is effective for complex calcified coronary lesions. However, IVL alone without imaging may lead to complications like balloon rupture and dissection.
Area of Science:
- Interventional Cardiology
- Cardiovascular Devices
- Medical Imaging
Background:
- Percutaneous coronary intervention (PCI) for calcified coronary lesions (CCLs) is challenging.
- Intravascular lithotripsy (IVL) shows promise but can have complications.
- Standalone IVL may not be sufficient for all CCLs.
Observation:
- A case of heavily calcified triple vessel disease with left main involvement is presented.
- Intravascular ultrasound (IVUS)-guided PCI with rotablation (RA) and IVL was performed.
- A complication occurred during IVL in the left circumflex artery, necessitating emergent stenting.
Findings:
- Rotablation with a small burr can favorably modify superficial calcium, facilitating IVL.
- IVL and RA are complementary for treating complex CCLs.
- The case highlights potential complications of IVL, such as balloon rupture and dissection.
Implications:
- Combining RA and IVL, guided by intravascular imaging, offers a safe approach for complex CCLs.
- Careful patient selection and imaging guidance are crucial for IVL use.
- This case underscores the importance of intravascular imaging to mitigate IVL-related risks.
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