Video : Calcified distal Left Main and LAD stenoses - Rotablation treatment and IVUS evalutation

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Cardiology / Coronary / Pci / Case in the box

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This 20-minute case concerns an 83-year-old man with stable angina, good LV function, and permanent atrial fibrillation on long-term anticoagulation.

This patient was first treated with a 1.75 millimeter burr on the RCA followed by DES.

Step-by-Step Procedure

Description of the challenge of the day
Placement of the Rotawire
Rotablation technique and rotablation cocktail
Rotablation of left main and left descending artery
Post dilatation and post IVUS evaluation
LAD and left main stenting, IVUS evaluation

Learning points

The use of the Rotablator on RCA
The placement of the Rotablator guidewire using a micro-catheter to exchange GW
The Rotablation cocktail and the Rotablation technique
IVUS evaluation after Burr debulking

Bibliography

Shooting date : 2016-12-15
Last update : 2021-05-11

IVUS / Philips

Rotablator Rotational Atherectomy System / Boston Scientific

10 comments

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Alexander P. The best!

2017-01-26, 14h48
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Mohamed sabry M. what about the mid segment of LAD? i think it is significant calcific and stenosed.

2017-03-04, 9h25
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Mohamed sabry M. very good..

2017-03-04, 10h39
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islam O. Can rotablator be used in case of ISR or contraindicated,when to start with ballon preparation befor shift to rotablator

2017-06-03, 18h50
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Max A. Rotablator have been used in case of ISR , but has an extremely limited role for several reasons.
Rotablator could be used carefully after balloon dilatation in case of undilatable lesion.

2017-06-04, 16h47
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narayana reddy B. Good result

2017-06-06, 4h04
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Babu E. Whether floppy or extra support rota wire used in this case for LAD?

2017-06-09, 17h55
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Babu E. What was the size of burr used in LAD? How to choose among 2.25mm , 2.5mm or 2.75mm burrs for a given vessel with lesion?

2017-06-09, 18h00
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bajarang B. want to see the full picture sir

2017-06-24, 17h05
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venkatesa reddy D. very well explained use of rota

2017-09-29, 3h01
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