Department of Medicine, Division of Cardiovascular Medicine
Cardiology | Cardiovascular Diseases
Severe coronary artery calcifications pose an ongoing challenge when performing percutaneous coronary interventions, resulting in an increased likelihood of procedural complications. Orbital atherectomy (OA) has emerged as a promising technology that helps improve outcomes in this complex patient population. Its safety and efficacy are yet to be demonstrated in the setting of acute myocardial infarction. We present a case of a patient with acute ST-elevation myocardial infarction (STEMI) evaluated with emergent transradial coronary angiography. The culprit lesion was a severely stenotic, heavily calcified, segment of the right coronary artery. The use of OA facilitated lesion expansion and implantation of a drug-eluting stent. Although OA should be considered as contraindicated for the management of soft-ruptured plaque, which accounts for the majority of STEMI presentations, it may be well applied to the small subset of patients with calcified nodule pathology, even in the acute setting.
ST-elevation myocardial infarction, calcium, coronary artery calcification, orbital atherectomy, percutaneous coronary intervention, transradial angiography, vessel preparation
Rights and Permissions
Copyright © 2016 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited.
DOI of Published Version
Interv Med Appl Sci. 2016 Dec;8(4):178-180. doi: 10.1556/1646.8.2016.4.3. Link to article on publisher's site
Interventional medicine and applied science
Mowakeaa S, Snyder B, Kakouros N. (2016). Use of orbital atherectomy in acute myocardial infarction via the transradial approach. Open Access Articles. https://doi.org/10.1556/1646.8.2016.4.3. Retrieved from https://escholarship.umassmed.edu/oapubs/3028