Document Detail


Dislocation of the rotating cutter during directional coronary atherectomy: a note of caution.
MedLine Citation:
PMID:  7553833     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Directional coronary atherectomy (DCA) has received increased attention, especially as a bail-out procedure after failed balloon angioplasty. However, this technique may also be burdened by severe pitfalls. We report a patient with a balloon-resistant left coronary artery lesion subsequently treated with DCA. Despite its over-the-wire guidance, as the rotating cutter was advanced, it deviated from its intra-housing course and intruded into the vascular wall. Dislocation of the rotating blade was due to pressure from hard plaque tissue. After having carefully pulled back the complete catheter system, a severe spasm of the left main stem occurred, which was reversed by intracoronary nitroglycerine. The final angiography showed a left coronary artery without significant, residual stenosis. The case report underscores that DCA passes must be performed under continuous fluoroscopic control, especially for balloon-resistant lesions because of the unpredictability of DCA-imminent complication.
Authors:
G Bauriedel; S Schluckebier; U Welsch; K Werdan; B Höfling
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular diagnosis     Volume:  35     ISSN:  0098-6569     ISO Abbreviation:  Cathet Cardiovasc Diagn     Publication Date:  1995 Jul 
Date Detail:
Created Date:  1995-11-14     Completed Date:  1995-11-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7508512     Medline TA:  Cathet Cardiovasc Diagn     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  244-9     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine I, University of Munich, Germany.
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MeSH Terms
Descriptor/Qualifier:
Atherectomy, Coronary / adverse effects,  instrumentation*
Coronary Angiography
Coronary Artery Disease / pathology,  radiography,  therapy
Coronary Vasospasm / drug therapy,  etiology
Equipment Failure
Humans
Male
Middle Aged
Nitroglycerin / therapeutic use
Vasodilator Agents / therapeutic use
Chemical
Reg. No./Substance:
0/Vasodilator Agents; 55-63-0/Nitroglycerin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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