Documentation of Transient Microvascular Dysfunction Caused by Percutaneous Transluminal Coronary Rotational Atherectomy With Myocardial Contrast Echocardiography

Abstract

Percutaneous transluminal high-speed coronary rotational atherectomy (PTCRA) with Rotablator (Heart Technology, Seattle, WA), using the principle of differential cutting, relies on the selective abrasion and pulverization of hard and calcified atherosclerotic plaque into microparticles by the diamond-studded elliptical burr with minimal damage to the normal vessel wall [1, 2]. This procedure has been successful in the treatment of complex coronary lesions with procedural success rates of over 95% [3]. However, coronary slow flow, coronary spasm, coronary dissection, and non-Q wave myocardial infarctions are all recognized complications of PTCRA [1-4]. Among them, the coronary slow flow, that is seen in < 10% of patients after PTCRA, is considered to occur as a result of