Rotational atherectomy
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Please Join in Editing This Page and Apply to be an Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [2] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.
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)