Difficult Stentablation with an Episode of Stuck and Entrapped Burr within the Underexpanded Stent

Abstract

SummaryStentablation by rotational atherectomy has been reported as an option to correct underexpanded stents. Due to concerns of excessive stent damage, distal embolization of metal particles, excessive heat generation, and burr entrapment in the stent, stentablation has been considered the last choice to manage underexpanded stents. Here, we report a case of a stuck and entrapped atherectomy burr inside an underexpanded and undilatable stent, which made withdrawal of therotablation burr during rotational atherectomy difficult. After successful stentablation by rotational atherectomy, we were able to complete the percutaneous coronary intervention with another stent.(Int Heart J Advance Publication)

Aterectomía rotacional coronaria en una lesión con reestenosis de stent subexpandido

“…If entrapment occurs, timely action is required to eliminate trapped abrasive burs, 8 it should be noted that the use of rotational atherectomy as a therapeutic measure for calcific atheromatosis has been highly effective, reporting a success rate greater than 90%. Furthermore, it has complication in less than 5% of cases; Complications have been reported during RA such as excessive stent damage, distal embolization of metallic particles, excessive heat generation, and trapping of the abrasive bur in the stent; 9 although various eventualities can occur during RA, the entrapment of the abrasive bur has been reported in 0.5 to 1% of these rare complications. 7 One way to solve this complication is to move the patient to an emergent surgical procedure, being the most reliable option to eliminate the trapped abrasive bur.…”