The limited antegrade subintimal tracking technique to retrieve a trapped rotablator burr: a case report.

Maznyczka, Annette; Mozid, Abdul (2024). The limited antegrade subintimal tracking technique to retrieve a trapped rotablator burr: a case report. European heart journal - case reports, 8(2) Oxford University Press 10.1093/ehjcr/ytae044

Preview

Text ytae044.pdf - Published Version Available under License Creative Commons: Attribution (CC-BY). Download (1MB) | Preview

BACKGROUND

Burr entrapment is a rare, but potentially serious complication of rotablation. This report describes the percutaneous options available for Rota burr retrieval.

CASE SUMMARY

A 62-year-old Caucasian man with stable angina presented for percutaneous coronary intervention. Attempted rotablation with a 1.75 mm burr resulted in Rota burr entrapment, in the heavily calcified proximal right coronary artery. A chronic total occlusion angioplasty technique (limited antegrade subintimal tracking) was successfully used to remove the trapped Rota burr, by enabling subintimal dilatation to externally crush plaque and dislodge the burr. The angioplasty procedure was then completed using the wire that had a short subintimal passage, before re-entering the true lumen.

DISCUSSION

The mechanism for Rota burr entrapment, in this case, was initiating rotablation on the heavily calcified lesion and not more proximal to allow a pecking motion. The learning points are (i) to start the rotablator several millimetres proximal to the actual lesion, and (ii) if unable to wire alongside a trapped Rota burr in the true lumen, then subintimal crossing and balloon dilatation in the subintimal space may work to dislodge the burr.

Interest & Impact

Downloads

13 since deposited on 13 Feb 2024
13 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item