Rotational atherectomy: Difference between revisions
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# Allowing a period of recovery between bur runs | # Allowing a period of recovery between bur runs | ||
# Avoid over-sizing the bur to minimize downstream embolization | # Avoid over-sizing the bur to minimize downstream embolization | ||
# Use of a "Rotablator flush": | |||
:*0.9% NS 1000 cc | |||
:*10,000 Units of unfractionated heparin (10 units / ml) | |||
:*Verapamil 10 mg (10 micrograms / ml) | |||
:*Nitroglycerin 5 mg (5 microgams / ml) | |||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
Revision as of 23:47, 17 April 2009
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Strategies to reduce no reflow during the procedure
- Liberal administration of calcium channel blockers such as diltiazem (200 micrograms administered via the intracoronary route)
- Multiple short runs of rotablation
- A slower initial speed of rotablation such as 140,000 to 160,000 rotations per minute (RPM)
- Minimal deceleration during the bur runs
- Allowing a period of recovery between bur runs
- Avoid over-sizing the bur to minimize downstream embolization
- Use of a "Rotablator flush":
- 0.9% NS 1000 cc
- 10,000 Units of unfractionated heparin (10 units / ml)
- Verapamil 10 mg (10 micrograms / ml)
- Nitroglycerin 5 mg (5 microgams / ml)