Rotational Atherectomy in Sub-Acute Anterior STEMI with Cardiogenic Shock

Abstract

Zaki Horizon Islami, Hendry Purnasidha Bagaswoto, Nahar Taufiq, Budi Yuli Setianto Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada – Dr. Sardjito Hospital, Yogyakarta, IndonesiaCorrespondence: Hendry Purnasidha BagaswotoDepartment of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada – Dr. Sardjito Hospital, Yogyakarta, IndonesiaTel [phone]Fax [phone]Email [email protected]: Rotational atherectomy (RA) is a proven technique to modify a heavily calcified coronary lesion if balloon angioplasty failed. RA is frequently avoided in ST-elevation myocardial infarction (STEMI) as it may increase the risk of slow or no-reflow. It is also considered to be relatively contraindicated in lesions with a visible thrombus, by its manufacturer. Regardless, RA may be a life-saving procedure in cases where no other percutaneous coronary intervention (PCI) technique is available to modify the lesion adequately. This case reports successful use of RA to facilitate dilation and stent delivery of a previously non-dilatable lesion in a patient with sub-acute anterior STEMI complicated by cardiogenic shock.Keywords: rotational atherectomy, heavily calcified culprit lesion, STEMI, cardiogenic shock

Keywords

• rotational atherectomy
• heavily calcified culprit lesion
• stemi
• cardiogenic shock