Rotational Atherectomy in Sub-Acute Anterior STEMI with Cardiogenic Shock

• Published in: International medical case reports journal Vol. 14; pp. 289 - 293
• Main Authors: Islami, Zaki Horizon, Bagaswoto, Hendry Purnasidha, Taufiq, Nahar, Setianto, Budi Yuli
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2021; Taylor & Francis Ltd; Dove; Dove Medical Press
• Subjects: Acute coronary syndromes; Angioplasty; Blood clot; Blood clots; Calcification; Cardiogenic shock; Case Report; Case reports; Catheters; Clopidogrel; Coronary vessels; Drug dosages; Electrocardiography; Endarterectomy; heavily calcified culprit lesion; Medical equipment and supplies industry; Medical imaging; Medical test kit industry; Optimization techniques; Pain; Patients; rotational atherectomy; stemi; Stent (Surgery); Stents; Success; Thrombosis; Transluminal angioplasty; Veins & arteries; Wire; United States; Ireland; Minneapolis Minnesota; United States > US; Chicago Illinois; STEMI; heavily calcified culprit lesion; rotational atherectomy; cardiogenic shock
• ISSN: 1179-142X; 1179-142X
• DOI: 10.2147/IMCRJ.S295649

Rotational atherectomy (RA) is a proven technique to modify a heavily calcified coronary lesion if balloon angioplasty failed. RA is frequently avoided in ST-elevation myocardial infarction (STEMI) as it may increase the risk of slow or no-reflow. It is also considered to be relatively contraindicated in lesions with a visible thrombus, by its manufacturer. Regardless, RA may be a life-saving procedure in cases where no other percutaneous coronary intervention (PCI) technique is available to modify the lesion adequately. This case reports successful use of RA to facilitate dilation and stent delivery of a previously non-dilatable lesion in a patient with sub-acute anterior STEMI complicated by cardiogenic shock.