Tips and tricks for performing Rotational atherectomy
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摘要: 冠状动脉旋磨术适用于严重钙化病变和球囊无法通过的CTO病变,不适用于血栓性病变、严重成角病变和冠状动脉夹层。经桡动脉旋磨与经股动脉相比,成功率相似,而前者出血并发症更少。旋磨术中,需选择合适的磨头、转速,操作要规范,以避免出现迷走反射、无血流/慢血流、冠状动脉穿孔、分支闭塞、球囊嵌顿等严重并发症。Abstract: Rotational atherectomy is very safe and effective for de novocoronary lesions with severe calcification and balloon-uncrossable chronic total occlusin before stent implanted.Rotational atherectomy should be avoided applying to thrombtic lesions,acutely angulated lesions and lesions with dissection.Rotational atherectomy through radial approach had similar procedural success and less bleeding complications when compared with the transfemoral route.Appropriate burr and rotational speed should be considerately selected befor rotation.Meticulous manipulation and strategies are neccessary to prevent and manage serious complications,including vascular vagus reflex,slow-flow/no-reflow,coronary perforation,side branch occlusion and burr entrapment.
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Key words:
- rotational atherectomy /
- manipulation /
- complication
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