Year: 2025
Type: article
Study design: Case Report
Abstract: right femoral arterial access.The left main was hooked with a 7F XB-3 guiding catheter, and the lesion was crossed with a workhorse percutaneous transluminal coronary angioplasty (PTCA) guidewire.Intravascular ultrasound (IVUS) was done, which showed heavily calcified osteoproximal to mid LAD with napkin-ring calcium for >5 mm length (calcium score 3/4), with unhealthy landing zone at ostial LAD.In view of the long deep calcific lesion, RotaTripsy was planned.With the help of microcatheter, workhorse PTCA wire was exchanged with Rota floppy wire.Then RA was done with 1.5 mm followed by 1.75 mm Rotalink burr (Boston Scientific) at around 1,60,000-1,80,000 RPM.Subsequently, IVUS was done with IntroductIonSevere coronary artery calcification presents a significant challenge in percutaneous coronary intervention (PCI), often impeding stent delivery and its expansion.Traditional calcium modification techniques, such as RA and IVL, have limitations when used independently.RotaTripsy synergistically integrates RA's ability to debulk superficial calcium with IVL's capacity to fracture deep concentric calcifications, facilitating optimal stent deployment.RotaTripsy is a novel technique combining rotational atherectomy (RA) and intravascular lithotripsy (IVL), especially used for complex calcific lesions. 1 Further addition of cutting balloon angioplasty after RA, a strategy termed as RotaCut, facilitates even better lesion preparation for adequate stent optimization. case descrIptIonA sexagenarian gentleman presented with complaints of angina on exertion Canadian Cardiovascular Society (CCS) III for 2 weeks.The patient was admitted for coronary angiography, which revealed severely calcific long segment angulated 90% stenosis in osteoproximal to mid left anterior descending (LAD), calcific discrete 50% proximal circumflex stenosis, ostial discrete 50% OM2 stenosis, and mild insignificant eccentric proximal right coronary artery (RCA) stenosis.The left main was normal (Fig. 1).In view of the severe calcific lesion, the patient was planned for imaging-guided PCI to LAD using calcium modification devices via
Institution: Seth Nandlal Dhoot Hospital
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W4415602940