Wire-entanglement retrieval of a detached rotational atherectomy burr after complete wire disengagement: a case report
Zhenzhen Ding, Mengzhang Wu, Qing Qin, Rende Xu, Jianying MaAbstract
Background
Rotational atherectomy is crucial for heavily calcified coronary lesions, but complications like burr entrapment, though rare, can be fatal.
Case Summary
A 55-year-old man with diffuse coronary stenosis underwent rotational atherectomy for a left circumflex artery lesion. During the procedure, the rotational atherectomy burr disconnected from the guidewire, and the wire subsequently disengaged entirely from the burr, leaving the burr retained. A novel wire-entanglement technique was successfully employed by advancing a Fielder XT-A guidewire through the burr's lumen and intentionally knuckling a Sion guidewire to intertwine with it. This maneuver loosened and dislodged the burr, allowing for controlled proximal migration and retrieval into the guiding catheter.
Discussion
This case presents a rare scenario of complete rotational atherectomy guidewire disengagement from the burr. The successful retrieval using a wire-entanglement technique offers a valuable percutaneous bailout strategy for similar challenging situations where traditional retrieval methods may fail.