Use of the orbital atherectomy system backed up with the guide-extension catheter for a severely tortuous calcified coronary lesion
Year: 2020
Type: article
Study design: Case Report
Abstract: A 68-year-old man was scheduled to undergo percutaneous coronary intervention for in-stent total occlusion of the severely tortuous right coronary artery. Intravascular ultrasound revealed heavy in-stent calcification. Lesion atherectomy was required; however, severe proximal vessel tortuosity was detected. We introduced a 7-Fr guide-extension catheter beyond the severely tortuous part and performed rotational atherectomy with a 1.5 mm burr. However, the balloon could not expand; therefore, we changed to an orbital atherectomy system. Subsequently, the balloon successfully expanded, and intravascular ultrasound revealed an enlarged lumen. Severe proximal vessel tortuosity limits the use of atherectomy devices; however, a guide-extension catheter delivers the atherectomy device beyond the tortuosity. The delivery of the orbital atherectomy system inside the guide-extension catheter is easy due to its low profile; the debulking effect increases with the number of passes and rotational speed. This strategy is a useful option for treating severe calcified lesions with proximal vessel tortuosity.
Source: SAGE Open Medical Case Reports
Authors: Norihiro Kobayashi, Masahiro Yamawaki, Keisuke Hirano, Motoharu Araki, Tsuyoshi Sakai, Yasunari Sakamoto, Shinsuke Mori, Masakazu Tsutsumi, Masahiro Nauchi, Naohiko Sahara, Yohsuke Honda, Kenji Makino, Shigemitsu Shirai, Masafumi Mizusawa, Yuta Sugizaki, Takahide Nakano, Tomoya Fukagawa, Toshihiko Kishida, Yuki Kozai, Yusuke Setonaga, Shutaro Goda, Yoshiaki Ito
Institution: Saiseikai Yokohama Eastern Hospital
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,000
OpenAlex ID: W3034879645