Successful Retrieval of an Entrapped Rotablator Burr by Using a Guideliner Guiding Catheter and a Snare

Abstract

Although burr entrapment is a rare complication of rotablation, it is extremely difficult to retrieve a stuck entrapped burr without surgical intervention. There are several techniques typically employed to retrieve an entrapped burr, using bailout endovascular approaches. Herein we have presented a new retrieval method involving a Guideliner child-in-mother catheter combined with a snare, which was used to successfully rescue a stuck rotablator burr.

Keywords: Coronary artery disease; Percutaneous coronary intervention.

Figure 1

(A) A diagnostic image of right coronary artery (RCA) showing the previous stent with moderate stenosis in the distal part. (B) Insertion of a 5.5 Fr Guideliner catheter through the remaining rotablator system and retrieval of the entrapped 2.0 mm burr with success.

Figure 2

(A) Another 2.15 mm burr was also entrapped in the critical stenotic site and the Guideliner was used again. (B) Pushed the Guideliner catheter as well as simultaneously pulled the rotablator system, resulted in shortening the vessel but the burr still entrapped. (C) Successful retrieval of the entrapped burr using a 4 mm gooseneck snare combined with a Guideliner catheter. (D) A photograph of a 2.15 mm RotaLink Plus in the Guideliner catheter also with a snare. (E) Final angiogram.