1.Mechanism and management of burr entrapment：A nightmare of interven-tional cardiologists
Chiapin LIN ; Jihung WANG ; Wenling LEE ; Poming KU ; Weihsian YIN ; Tenping TSAO ; Chijen CHANG
Journal of Geriatric Cardiology 2013;(3):230-234
Entrapment of the burr within calcified lesion is an uncommon, but serious complication during rotational atherectomy and usually needs surgical retrieval. We report a case series of this complication and also review the possible mechanisms, such as kokesi phenomenon or insufficient pecking motion with decreased rotational speed. We also review the potential techniques ever proposed to rescue this complica-tion percutaneously, including simple manual traction, balloon dilation to release the trap, snaring the burr as distal as possible for forceful local traction and wedging the burr with a child catheter to facilitate retrieval. Gentle pecking motion of the burr for sufficient ablation and shortening the run less than 15 s may avoid such complications. Interventional cardiologists using the rotablator should be familiar with the tips and tricks to avoid and rescue this complication.
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