A Case of Favorable Dilation of Protected Left Main Coronary Artery Lesion Achieved Through Performance of Adjunctive DCA on Residual Stenosis Following Use of Rotablator

Abstract

It is believed that directional coronary atherectomy (DCA) is more suitable than percu taneous transluminal coronary angioplasty for lesions such as severe eccentric lesions, ostial lesions, and branch lesions. However, it remains a fact that lesions that are also highly calcified are often suboptimal, since there may be difficulties such as in insertion of the housing and in sufficient cutting and removal. On the other hand, Rotablator is effective on calcified lesions, but afterward, dilation by balloon angioplasty for residual stenosis becomes necessary in many cases. This is a report of the authors' experience on an interesting case in which favorable dilation of a lesion in the protected left main coronary artery (LMCA) was achieved by using Rotablator after confirmation of a high degree of calcification by means of intravascular ultrasound (IVUS) echocardiograhy, followed by the performance of DCA on the residual stenosis.