Use of rotational atherectomy in chronic total occlusion percutaneous revascularization
█ Case report
Karácsonyi Judit, Nagy Ferenc, Sasi Viktor, Katona András, Ungi Imre
Szegedi Tudományegyetem, Általános Orvostudományi Kar, II. sz. Belgyógyászati Klinika és Kardiológiai Központ, Invazív Kardiológiai Részleg, Szeged
Percutaneous revascularization of chronic total occlusions is a fast evolving field of interventional cardiology. Novel techniques and new tools have led to higher procedural success rates accompanied by acceptable risk in these complex interventions. Although failure to cross the lesion with a guide-wire remains the main cause of procedural failure, one of the most frustrating situations after successful intraluminal wiring is presented by balloon uncrossable and/or undilatable lesions mainly due to calcification. In our publication we discuss the most commonly used application to treat such lesions, rotational atherectomy highlighted by two cases. In the first case rotational atherectomy was used successfully for the antegrade recanalization of a balloon uncrossable chronic total occlusion. While in the second case a retrograde wired ostial chronic total occlusion was successfully passed antegrade by using a rotational atherectomy device. Both cases resulted in successful recanalization without any procedural complications, demonstrating the usefulness of rotational atherectomy as an important tool in percutaneous intervention of calcified chronic total occlusions with high success and low complication rates.