Percutaneous rotational coronary atherectomy: initial Green Lane and Mercy hospitals' experience

Rotational atherectomy is a new interventional technique and can be used as an alternative percutaneous treatment for selected coronary atherosclerotic lesions. We report the initial Green Lane/Mercy hospitals experience with rotational atherectomy and review the published international experience with the device.

Patient case notes and prospectively recorded New Zealand national angioplasty data forms were reviewed for basic demographic data and angina symptoms, in-hospital complications and length of the hospital stay. Catheter laboratory worksheets were reviewed to obtain the duration of ablation, burr diameter and adjunctive PTCA balloon diameter.

The main indications for rotational atherectomy were heavy lesion calcification, ostial location, or failure of an angioplasty balloon to cross or to dilate the lesion. Procedural success was achieved in 28 of 30 patients (93%). One patient suffered a Q wave myocardial infarction and in another the lesion could not be crossed with the guide wire. Two patients required repeat balloon angioplasty for early reocclusion without other sequelae and one patient had directional atherectomy 2 weeks later for ongoing sumptoms.

Rotational atherectomy is a useful adjunct to the percutaneous devices available to treat coronary disease.