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  • Potent Stent-Less Procedure Using Rotational Atherectomy and Drug-Coated Balloon to Right Coronary Ostial Lesion

    • Posted: 10/03/2019
    • Author:

      Jun Shiraishi, Tetsuro Nishimura, Masayoshi Kimura, Nariko Koshi, Yuki Matsubara, Daisuke Ito, Eigo Kishita, Yusuke Nakagawa, Masayuki Hyogo and Takahisa Sawada

    • CRM2019

    Highlights

    • Revascularization therapy for de novo calcified RCA ostial lesion remains to be a problem.
    • Revascularization therapy for refractory in-stent restenosis due to calcified nodule remains to be established.
    • Rotational atherectomy followed by drug-coated balloon dilation alone is proposed as a choice.

    Abstract

    Background

    Even in the drug-eluting stent era, ostial lesion of the right coronary artery (RCA) still remains therapeutic challenge for interventional cardiologists. Case Series Case 1 (76 y.o. male) with angina on effort underwent transradial stent-less percutaneous coronary intervention (PCI) using rotational atherectomy (RA) followed by drug-coated balloon (DCB) dilation alone (RA/DCB) against a calcified de novo RCA ostial lesion. Case 2 (86 y.o. female) with recurrent unstable angina and hemodialysis underwent transfemoral RA/DCB against a severe repeat in-stent restenosis probably due to calcified nodule in the RCA ostium. In the both patients, PCI was successfully completed under intravascular ultrasound imaging (IVUS) guidance without complications. Follow-up CAG performed 4–5 months after the procedure revealed no significant lumen narrowing in the both RCA ostial lesions.

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