Rotational atherectomy in atherosclerotic rabbit iliac arteries

An evidence‐based approach to the use of rotational and directional coronary atherectomy in the era of drug‐eluting stents: When does it make sense?

“…Rotational atherectomy (RA) was developed by Dr. David C. Auth and was first introduced in the late 1980s as a method of ablating atheromatous plaques [11,12]. It is currently commercially available as the Rotablator System (Boston Scientific, Scimed) and consists of a nickel-plated, brass burr which is coated with diamond chips rotating at 140,000-190,000 rpm (see Fig.…”

“…The physical principal governing RA is known as differential cutting. Differential cutting results in the destruction of inelastic material such as atherosclerotic, calcified, and fibrotic plaques while sparing normal elastic tissue [11,13]. Selective removal of calcified, fibrotic, and lipid rich plaques without significant arterial expansion has been demonstrated by IVUS studies [14][15][16].…”

Role of Rotational Atherectomy in Percutaneous Coronary Interventions in Elderly

“…The procedure entails a diamond encrusted elliptical burr that is rotated at high speeds (140,000-180,000 rpm) and advanced over a guidewire across the lesion [5]. The guidewire functions to keep the burr coaxial in the lumen of the artery.…”

“…The final lumen diameter is larger that the size of the burr that is used. Most of the particles creating during RA are smaller than 10um (mean diameter of 5um) and easily traverse the microvascularture to be absorebed by the RES [5]. In some cases, the microvasculature can be obstructed causing reduced contractility, slow flow-no reflow and MI.…”

Angiographic analysis of immediate and long‐term results of PTCR vs. PTCA in complex lesions (COBRA study)

“…Rotational ablation effectively ablates obstructive coronary artery plaques [1,2]. It is mainly used in complex coronary artery lesions because of its mechanism of action, which causes less trauma to the vessel wall as compared with balloon angioplasty [3].…”