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- Title
Use of the orbital atherectomy system backed up with the guide-extension catheter for a severely tortuous calcified coronary lesion.
- Authors
Kobayashi, Norihiro; Yamawaki, Masahiro; Hirano, Keisuke; Araki, Motoharu; Sakai, Tsuyoshi; Sakamoto, Yasunari; Mori, Shinsuke; Tsutsumi, Masakazu; Nauchi, Masahiro; Sahara, Naohiko; Honda, Yohsuke; Makino, Kenji; Shirai, Shigemitsu; Mizusawa, Masafumi; Sugizaki, Yuta; Nakano, Takahide; Fukagawa, Tomoya; Kishida, Toshihiko; Kozai, Yuki; Setonaga, Yusuke
- 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.
- Publication
SAGE Open Medical Case Reports, 2020, Vol 8, p1
- ISSN
2050-313X
- Publication type
Article
- DOI
10.1177/2050313X20921081