Rotational Atherectomy through Inner Guiding Catheter System for 1.25 mm Rotational Burr Non-Crossable Heavily Calcified Coronary Stenosis

Abstract

The development of various techniques and equipments for percutaneous coronary artery intervention (PCI) has led to an increase in age of the PCI population, and an increase in complexity of cases such as chronic total occlusion and calcified lesion. However, on the other hand, these subsets can increase the rate of balloon failure (inability to cross or dilate a coronary stenosis with a balloon) [1]. Among the many devices for PCI, rotational atherectomy (RA) has shown high procedural success rates with non-crossable calcified stenosis [2]. It is well known that RA for this frustrating subset is limited by the required size of guiding catheters and the ability to cross the lesion with a dedicated RotaWire [3], and 1.25 mm burr passage failure after successful RotaWire delivery is uncommon situation. In this report, we present a case in which 1.25 mm rotational burr non-crossable heavily calcified lesion was successfully treated by the RA through 6 in 8Fr inner guiding system.