Rotational atherectomy is useful to treat restenosis lesions due to crushing of a sirolimus-eluting stent implanted in severely calcified lesions: Experimental study and initial clinical experience

Atsunori Okamura, Hiroshi Itoh, Kenshi Fujii

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8 Citations (Scopus)

Abstract

We have occasionally encountered restenosis due to the crushing of drug-eluting stents (DES) implanted in severely calcified lesions. We aimed to establish the role of rotational atherectomy (RA) in its treatment. At first, we conducted an experimental study and found that the size of the metallic particles generated during RA of stent struts was 5.6 ± 3.6 μm. We performed RA on the restenosis of the sirolimus-eluting stents implanted in the severely calcified lesions of a 66-year-old male who had received hemodialysis for 13 years. He had restenosis in the proximal and mid-segments of the right coronary artery, and intravascular ultrasound images documented that these stents were crushed by calcified plaque behind them. RA ablated both crushed stent struts and the calcified lesions behind them, and there was no hemodynamic derangement during the procedure. Maximum dilatation of the lesions was achieved with balloon angioplasty, followed by stent implantation. RA is an effective strategy to treat restenotic lesions resulting from the crushing of DES in severely calcified lesions.

Original languageEnglish
JournalJournal of Invasive Cardiology
Volume21
Issue number10
Publication statusPublished - Oct 2009
Externally publishedYes

Fingerprint

Coronary Atherectomy
Sirolimus
Stents
Drug-Eluting Stents
Balloon Angioplasty
Particle Size
Renal Dialysis
Dilatation
Coronary Vessels
Hemodynamics
Clinical Studies

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

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title = "Rotational atherectomy is useful to treat restenosis lesions due to crushing of a sirolimus-eluting stent implanted in severely calcified lesions: Experimental study and initial clinical experience",
abstract = "We have occasionally encountered restenosis due to the crushing of drug-eluting stents (DES) implanted in severely calcified lesions. We aimed to establish the role of rotational atherectomy (RA) in its treatment. At first, we conducted an experimental study and found that the size of the metallic particles generated during RA of stent struts was 5.6 ± 3.6 μm. We performed RA on the restenosis of the sirolimus-eluting stents implanted in the severely calcified lesions of a 66-year-old male who had received hemodialysis for 13 years. He had restenosis in the proximal and mid-segments of the right coronary artery, and intravascular ultrasound images documented that these stents were crushed by calcified plaque behind them. RA ablated both crushed stent struts and the calcified lesions behind them, and there was no hemodynamic derangement during the procedure. Maximum dilatation of the lesions was achieved with balloon angioplasty, followed by stent implantation. RA is an effective strategy to treat restenotic lesions resulting from the crushing of DES in severely calcified lesions.",
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AU - Fujii, Kenshi

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