Capture of Part of a Vessel Wall by a Coronary Orbital Atherectomy System

Abstract

An 82-year-old man who had undergone coronary artery bypass grafting, aortic/mitral valve replacement, and tricuspid valvuloplasty was seen for exertional angina. On angiography, a severely stenotic lesion of the distal left internal thoracic artery (LITA) was noted, which was a bypass graft to the left anterior descending (LAD) artery (Fig. 1A, arrow). The LAD artery showed chronic total occlusion (CTO; Fig. 1B, arrow). We thought that if an angioplasty for the stenotic lesion in the LITA failed, then significant damage would occur in the LAD artery area.