Rotational Atherectomy

Overview

4 out of 5 (1 Reviews)

Credits

1.50

Post Assessment Questions

10

Start Date

1 Mar 2023

Last Review Date

3 Jul 2023

Expiration Date

28 Feb 2026

Estimated Time To Finish

90 Minutes

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Activity Description

Coronary stenoses with circumferential or significant vessel calcification are rigid and frequently not dilatable with use of conventional balloon angioplasty. Often stent dilation and maximal vessel wall apposition are compromised in extensively calcified coronary lesions, stents deployed in heavily calcified vessels without atherectomy tend to thrombose, restenosis, and could cause stent fracture. Significant calcification remains a major limitation of balloon angioplasty as well as successful stent delivery to severely affected vessels. In cases with heavily calcified lesions, high-pressure, non-compliant balloon inflations may still fail to dilate adequately and prepare a heavily calcified vessel for stent delivery. This activity reviews the indications, contraindications, and complications of rotational atherectomy and highlights the role of the interprofessional team in the management of patients with CAD. Atherectomy refers to the removal of the obstructing material, and in our case this is calcium. By removing significant calcification or modifying the calcified atherosclerotic plaque vessel wall compliance in calcified or fibrotic lesions is increased, and the lumen diameter gained from using this device will be much improved as compared to the use of simple balloon angioplasty. Rotational atherectomy is one of several ways to perform atherectomy in a coronary vessel. It is the most commonly used atherectomy device and removes atheromatous plaque by differential cutting, that is removing the inelastic calcified plaque with microscopic (20 to 50 micrometers) diamond chips embedded on the surface of a rapidly rotating (150,000 to 200,000 rpm) olive-shaped burr. Such abrasion generates 2 to 5-micrometer microparticles that propagate through the coronary microcirculation and are removed by the reticuloendothelial system. The burr travels over a specialized 0.009-inch guidewire and is available in diameters ranging from 1.25 to 2.50 mm. In the setting of severe calcification, smaller burr sizes should be used initially, followed by larger burrs in 0.25 to 0.50-mm increments up to 70% of the reference vessel diameter. This activity describes rotational atherectomy, and explains the role of the interprofessional team in managing patients who undergo this procedure.

Target Audience

This activity has been designed to meet the educational needs of physicians.

Learning Objectives

At the conclusion of this activity, the learner will be better able to:

  • Describe the technique of rotational atherectomy.
  • Review the indications for rotational atherectomy.
  • Summarize the complications of rotational athetectomy.
  • Explain the importance of improving care coordination among interprofessional team members to improve outcomes for patients undergoing rotational atherectomy.

Disclosures

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COMMERCIAL SUPPORT: This activity has received NO commercial support.

Continuing Education Accreditation Information

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Quillen College of Medicine, East Tennessee State University, and StatPearls, LLC. The Quillen College of Medicine, East Tennessee State University is accredited by the ACCME to provide continuing medical education for physicians.

Quillen College of Medicine, East Tennessee State University designates this activity for a maximum of 1.50 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Instructions for Credit

  1. Register for the activity and create a StatPearls login.     
  2. Review the target audience, learning objectives, and disclosure information.
  3. Study the educational content in the activity.
  4. Choose the best answer to each activity test question. To receive credit, you must pass the test questions with a minimum score of 100%.
  5. Complete the post-activity assessment.
  6. Obtain a certificate.

For information on the applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

Disclaimer

Faculty may discuss investigational products or off-label uses of products regulated by the US Food and Drug Administration. Readers should verify all information before employing any therapies described in this educational activity.

The information provided for this activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition. The information presented does not necessarily reflect the views of StatPearls or any commercial supporters of educational activities on statpearls.com. StatPearls specifically disclaims responsibility for any adverse consequences resulting directly or indirectly from information in the course, for undetected error, or through a participant's misunderstanding of the content.

Cancellation Policy: Cancellations must be received in writing and a money-back guarantee is provided if not completely satisfied.

  • StatPearlsand and Quillen College of Medicine, East Tennessee State University reserve the right to cancel any course due to unforeseen circumstances. StatPearls andQuillen College of Medicine, East Tennessee State University will not be responsible for other expenses incurred by the participant in the unlikely event that the program is canceled.

Medium or Media Used:

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Equal Opportunity

  • StatPearls andQuillen College of Medicine, East Tennessee State University are Equal Opportunity/Affirmative Action/Equal Access Institutions. 

 

 
 

Reviews

Maureen W. on 2/5/2023

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