Successful Retrieval of Retained Rotablator Burr in the Mid Left Anterior Descending Coronary Artery using a
Yoshitha Inala1, Jon Robken2, Nicolas W Shammas1,2
1Department of Cardiovascular Research, Midwest Cardiovascular Research Foundation, Davenport, Iowa.
Insights
A rare Rotablator atherectomy complication occurred during coronary intervention, involving a fractured drive shaft and retained burr. Successful extraction was achieved using retrograde total occlusion recanalization, showcasing advanced interventional cardiology techniques.
Area of Science:
- Interventional Cardiology
- Cardiovascular Surgery
- Medical Device Complications
Background:
- Percutaneous coronary intervention (PCI) is a common procedure for coronary artery disease.
- Rotablator atherectomy is used to treat complex coronary lesions.
- Coronary artery bypass graft (CABG) surgery is a prior intervention for some patients.
Observation:
- A 67-year-old patient with a history of coronary artery disease and prior CABG surgery experienced a rare complication during Rotablator atherectomy.
- The Rotablator drive shaft fractured, leading to the retention of the Rotablator burr in the mid left anterior descending coronary artery.
- This complication presented significant management challenges.
Findings:
- The retained Rotablator burr was successfully extracted using a retrograde total occlusion recanalization technique.
- This case highlights a rare but serious complication associated with Rotablator atherectomy.
Implications:
- Understanding and anticipating such rare complications is crucial for interventional cardiologists.
- Advanced techniques like retrograde recanalization are vital for managing complex PCI-related issues.
- This case underscores the importance of meticulous technique and preparedness in interventional cardiology procedures.
Abstract:
We present a rare complication of Rotablator (Boston Scientific) atherectomy during percutaneous coronary intervention in a 67-year-old patient with a history of coronary artery disease and prior coronary artery bypass graft (CABG) surgery. The fracture of the Rotablator drive shaft and retention of the Rotablator burr in the mid left anterior descending coronary artery posed significant challenges in patient management. This case demonstrates the successful extraction of the retained Rotablator burr using retrograde total occlusion recanalization and highlights the importance of understanding the potential complications and management strategies in complex interventional cardiology procedures.
