Stuck Between a Rock and a Hard Place

Rey, Florian; Nosair, Mohamed; Ly, Hung Q.

doi:10.1016/j.jaccas.2019.11.004

Cited by 3 publications

(2 citation statements)

References 4 publications

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“…Importantly, subintimal stenting (with stent in true lumen distal and proximal to the subintimal segment) has been shown to have similar long-term outcomes as stents entirely in the true lumen. 11 In contrast to previous reports of subintimal tracking to dislodge a stuck Rota burr, 8 , 9 our case had a longer-term angiographic follow-up, and this revealed an excellent result ( Figure 5 ).…”

Section: Discussioncontrasting

confidence: 83%

“… 6 , 7 Previous reports have described the Subintimal Tracking and Re-entry (STAR) technique, to spontaneously re-enter the true lumen from the subintimal space (usually at a distal bifurcation), using a polymer-jacketed wire with a low-gram tip load, such as Fielder XT (Asahi Intecc, Irvine, CA, USA). 6 , 8 , 9 The potential advantage of the LAST technique, compared with STAR, is that re-entry into the true lumen can usually be more predictable, with a lower risk of side branch loss. 10 Using IVUS, we demonstrated excellent stent expansion, despite the subintimally stented segment.…”

Section: Discussionmentioning

confidence: 99%

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

Maznyczka,

Mozid

2024

European Heart Journal - Case Reports

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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 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 millimeters 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.

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Section: Discussioncontrasting

confidence: 83%