Villavicencio FR, Uribe GJ, Barragán GO, Lupi HE

Language: Spanish
References: 11
Page: 221-227
PDF size: 537.07 Kb.

ABSTRACT

A heavily calcified atherosclerotic lesion is a challenge for any interventional cardiologist. This type of lesions can have good results with conventional angioplasty techniques. However, some lesions cannot be crossable, expandable or easily complicated by dissection or perforation. For these cases, rotational atherectomy for lesion preparation before deploying drug-eluting stents is the most reasonable option. In this case, rotational atherectomy was conducted by first intention due to the high density of calcium in the critical stenosis. There was significant difficulty to cross the lesion, so two microcatheters were used to cross the critical stenosis and then a rotablation was done with 1.25 and 1.75 mm olives, complemented with balloon angioplasty and the placement of two overlapped biolimus eluting stents. In the next article a review of several retrospective studies like The Rotalink I, and randomized studies like Rotaxus are analyzed, these studies compared the performance of drug eluting stents with rotational atherectomy or with conventional angioplasty techniques. In such way, the experience and intuition of the operator to use rotational atherectomy in complex cases that can predict a higher complication rate with conventional angioplasty techniques and undoubtely non-dilatable lesions will be the indication for using rotational atherectomy before placing drug-eluting stent, which have shown long-term reduction of restenosis, revascularization rates and major adverse cardiac effects.

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