Rotational atherectomy for calcified lesions during ST-segment elevation myocardial infarction: a case series and literature review
Kristen N Brown1, Aravdeep S Jhand2, Yiannis Chatzizisis3
1Division of Cardiovascular Diseases, University of Nebraska Medical Center, 4200 Emile St., Omaha, NE 68198, USA.
Insights
Rotational atherectomy (RA) is a feasible option for treating severely calcified lesions during ST-elevation myocardial infarction (STEMI) when standard equipment fails. This approach safely facilitates stent delivery and improves patient outcomes.
Area of Science:
- Interventional Cardiology
- Cardiovascular Medicine
- Medical Devices
Background:
- ST-elevation myocardial infarction (STEMI) traditionally contraindicates rotational atherectomy (RA).
- Severely calcified lesions pose challenges for stent delivery in STEMI patients.
- RA may be essential for revascularization in complex STEMI cases.
Background:
ST elevation myocardial infarction (STEMI) has traditionally been a relative contraindication for the utilization of rotational atherectomy (RA). However, in severely calcified lesions, RA may be necessary to facilitate stent delivery.
Case Summary:
Three patients who present with STEMI are found to have severely calcified lesions on intravascular ultrasound. Equipment was unable to pass the lesions in all three cases. Rotational atherectomy was therefore performed to allow for stent passage. All three cases had achieved successful revascularization with no intraoperative or post-operative complications. The patients remained angina-free the rest of their hospitalization and at the 4 month follow-up.
Discussion:
Rotational atherectomy for calcific plaque modification during STEMI when equipment will not pass is a feasible and safe therapeutic option.
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