Key result
Rotational atherectomy achieved successful revascularization without complications in 3 STEMI patients with uncrossable severely calcified lesions, who remained angina-free at 4 months.
Why the study?
STEMI has traditionally been a relative contraindication for rotational atherectomy, but in severely calcified lesions it may be necessary to facilitate stent delivery.
Does rotational atherectomy allow for safe and successful revascularization in patients with STEMI and severely calcified lesions when standard equipment cannot pass?
Case Report (n=3)
Does rotational atherectomy allow for safe and successful revascularization in patients with STEMI and severely calcified lesions when standard equipment cannot pass?
Rotational atherectomy is a feasible and safe therapeutic option for calcific plaque modification during STEMI when standard equipment cannot pass, despite being traditionally considered a relative contraindication.
RA may enable stent delivery in select STEMI cases with refractory calcification; hypothesis-generating and should not yet change practice.
Background: ST elevation myocardial infarction (STEMI) has traditionally been a relative contraindication for the utilization of rotational atherectomy (RA). However, in severely calcified lesions, RA may be necessary to facilitate stent delivery. Case summary: Three patients who present with STEMI are found to have severely calcified lesions on intravascular ultrasound. Equipment was unable to pass the lesions in all three cases. Rotational atherectomy was therefore performed to allow for stent passage. All three cases had achieved successful revascularization with no intraoperative or post-operative complications. The patients remained angina-free the rest of their hospitalization and at the 4 month follow-up. Discussion: Rotational atherectomy for calcific plaque modification during STEMI when equipment will not pass is a feasible and safe therapeutic option.
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Brown et al. (2023) conducted a case report in ST-segment elevation myocardial infarction (STEMI) with severely calcified lesions (n=3). Rotational atherectomy was evaluated on Successful revascularization and complications. Rotational atherectomy achieved successful revascularization without complications in 3 STEMI patients with uncrossable severely calcified lesions, who remained angina-free at 4 months.
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