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Complication: Dislodged Burr

Chapter
Part of the Clinical Cases in Interventional Cardiology book series (CCIC)

Abstract

The patient was an 84-year-old Chinese male, with a significant history of diabetes mellitus, hypertension, hyperlipidemia, and previous stroke. He had a recent admission for non-ST-elevation myocardial infarction (NSTEMI) for which an angiogram showed calcified triple vessel disease and significant left main (LM) disease (Figs. 24.1 and 24.2, Videos 24.1 and 24.2). He was offered coronary angiography bypass grafting at that time but declined. Currently, he was readmitted for recurrent NSTEMI and acute pulmonary edema requiring intubation. Due to hemodynamic instability, a multidisciplinary team decision was made for urgent revascularization by percutaneous coronary intervention.

Supplementary material

Video 24.1

Calcified left main bifurcation and LCX disease (MP4 2831 kb)

Video 24.2

Calcified left main bifurcation and diffuse LAD disease (MP4 3712 kb)

Video 24.3

Initial burring with 1.25 mm burr (MP4 11416 kb)

Video 24.4

Separated and dislodged rotaburr in LM (MP4 1149 kb)

Video 24.5

Initial attempt at removal of rotablation assembly. Note the driveshaft being pulled back in the guide catheter (MP4 11419 kb)

Video 24.6

Removal of entire rotablation assembly. Observe the rotaburr coming back into the guide together with the wire. Substantial force had to be applied. There is risk of ostial LM dissection with the force required to pull the burr out. Fortunately, this did not occur (MP4 9996 kb)

Video 24.7

Successful repeat rotablation with new 1.25 mm burr (MP4 11453 kb)

Video 24.8

Successful repeat rotablation with new 1.25 mm burr (MP4 11405 kb)

Video 24.9

Angiogram after rotablation (MP4 2623 kb)

Video 24.10

Final angiograms showing satisfactory results (MP4 3912 kb)

Video 24.11

Final angiograms showing satisfactory results (MP4 4439 kb)

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Department of CardiologyNational Heart Centre SingaporeSingaporeSingapore

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