Introduction In 1987 Jerome Ritchie, David Auth and colleagues first introduced rotational atherectomy (rotablation) as a technique for the endovascular treatment of obstructive atherosclerotic disease. Rotational atherectomy covers 3-5% of all procedures in big PCI centers, while <1% in smaller centers. By study of Warth DC et al. in 1994, at early period when it was first introduced, procedure complication of rotablation was about 40%, those with coronary dissection 29%, coronary artery occlusion 11.2%, side branch occlusion 1.8%, distal occlusion 0.9%, no relow phenomenon 6.1%, severe vasospasm 13.8% and vascular perforation 1-2%.
By advanced techniques and technologies that kind of complications reduced significantly, it occurs as same as other PCI procedures.
In our country PCI procedure was first introduced in Third State Central Hospital in 2000, since then 20 years has passed. During this period coronary intravascular diagnosis and treatment developed progressively performing 14751 PTCA procedures, of those 8355(56,6%) PCI cases. By statistics of 2017, myocardial infarction occurred 1145.6 in 10000 population, showing sharp increase, and cardiovascular mortality became number one cause and has tendency to increase further.
To inform first outcome of rotational atherectomy of atherosclerosis that is severely calcified and unavailable to introduce balloon catheter or stent. To conduct atherectomy treatment methods, accustoming professionals, order and get ready the treatment materials for necessity.
We successfully performed rotablation in severely calcified mLAD of 56 years of male patient by staged PCI, whose infarct related artery Lcx was revascularized 3 months previously. As a result the patient was fully revascularized, the balloon catheter passed through the narrowing and stent was implanted successfully.