Abstract
A 75-year-old man with a history of CAD with prior CABG, DM, HTN, and CKD presented with NSTEMI. While the left-sided system was well revascularized, the graft to the RCA was occluded and the decision was made to perform PCI on the heavily calcified and tortuous RCA. With a “shepherd’s crook” at the proximal RCA, rotational atherectomy was attempted, but likely led to the complication of formation of a “gutter.” Guttering is a known complication of rotational atherectomy and can be treated conservatively or aggressively.
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Reference
Tomey MI, Kini AS, Sharma SK. Current status of rotational atherectomy. J Am Coll Cardiol Intv. 2014;7(4):345–53.
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Stauber, B.D., Low, R.I., Singh, G.D. (2018). Complex Case: Rota Gutter in RCA. In: Low, R., Yeo, K. (eds) Clinical Cases in Coronary Rotational Atherectomy. Clinical Cases in Interventional Cardiology. Springer, Cham. https://doi.org/10.1007/978-3-319-60490-9_16
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DOI: https://doi.org/10.1007/978-3-319-60490-9_16
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