Format

Send to

Choose Destination
Catheter Cardiovasc Interv. 2018 Jul 18. doi: 10.1002/ccd.27674. [Epub ahead of print]

Broken arrow: Successful retrieval of a dislodged coronary orbital atherectomy microtip.

Author information

1
Department of Medicine, Section of Cardiology, University of Chicago Medical Center, Chicago, Illinois.

Abstract

A 68-year-old female with a history of coronary artery disease and prior bypass surgery presented for staged percutaneous coronary intervention (PCI) to a calcified and angulated ostial left circumflex (LCX) artery lesion after PCI of the anastomosis of the left internal mammary artery - to left anterior descending artery. Orbital atherectomy of the LCX was performed at a speed of 80,000 RPM with multiple passes, and was complicated by device microtip dislodgement and entrapment within the vessel. After advancing a "buddy" wire beyond the microtip, a tapered microcatheter was advanced over the ViperWire and into the edge of the broken microtip and torqued into the microtip with forward pressure using the 0.014 in ViperWire tip as a "backstop." The guidewire, microcatheter, and microtip were then successfully removed as a unit and the intervention with stent placement was completed over the "buddy" wire. Scanning electron microscopy of the shaft revealed evidence of cyclic fatigue, indicating that the fracture occurred while spinning. The fracture when performing atherectomy in a model coronary artery with a radius of approximately 6 mm. This represents a first case of microtip dislodgement and entrapment during the use of a coronary orbital atherctomy device.short.

KEYWORDS:

calcified plaques; coronary atherectomy; stable angina

PMID:
30019818
DOI:
10.1002/ccd.27674

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center