Stentablation with Rotational Atherectomy for the Management of Underexpanded and Undilatable Coronary Stents
Highlights
- • Stentablation of underexpanded undilatable coronary stents with rotational atherectomy is viable.
- • Stentablation has demonstrated high rates of procedural success with minimal periprocedural complications.
- • Reported prevalence of in-hospital MACE is low and short-term outcomes excellent.
- • On long-term follow-up, MACE is not uncommon and driven by high prevalence of target lesion revascularization (TLR).
- • The reported impact on mortality (0–25%) and recurrent MI (6.6–16.7%) is variable and remains uncertain.
Abstract
Stentablation with rotational atherectomy for the management of undilatable underexpanded coronary stents is a unique application associated with excellent periprocedural and in-hospital outcomes. Data regarding long-term outcomes remains limited, however the procedure appears to be associated with high prevalence of target lesion revascularization. Given the complexity of such lesions and few available interventional remedies; it is a reasonably safe and widely available approach of which operators should be aware. When stentablation is performed, the principles which guide contemporary rotational atherectomy and percutaneous coronary intervention, including intravascular imaging, should be applied.