Rotational Atherectomy Flashcards
What is the resultant particulate matter diameter after rotational atherectomy?
less than 10 micrometers
What system is the resultant particulate matter pass through and picked up by?
-Microcirculation
-Reticuloendothelial system
What are the indications of RA? (4)
-Prepare vessels with severe fibrocalcific disease that balloons or stents could not pass
-Passing through stents could dislodge or erode drug coating
-Inadequate drug delivery to vessel wall
-Risks of balloon ruptures
What is RA also used for in bifurcation lesions?
Debulk to reduce plaque shift
“Snow plowing effect”
What is the relative contraindication for angulation on Rotational Atherectomy?
more than 60 degrees between main vessel and side branch
What is a strong conterindications for RA in angulation?
More than 90 degrees
What is the relative contraindication for lesion length in RA?
more than 25 mm in length
What used to be a contraindication for RA but now is advent with support devices such as the Impella catheter?
Ejection Fraction <30%
What is a Rotablator system made our of?
Nickel-coated brass burr and coated with 2000 to 3000 microscopic diamond crystals that are 20 micrometers in size.
What is the inch diameter of the Roata wire and length?
0.009 in diameter
330 cm length
What is the speeds ranging from in rotations for the Rotablator
140,000 to 220,000 rpm
What is the rotaglide emulsifier solution made out of? (3)
Egg yolk
EDTA
Olive Oil
Saline
For patent but stenotic vessels, a burr to artery ratio is?
Less than 0.6
If the arterial size is difficult to ascertain, what size burr should you start with?
1.25 or 1.5 mm
What medication is given to anticoagulate and prevent spasm?
-Aspirin
-Verapamil (Spasm)
-Heparin
-Bivalirudin
What burr is used for patients with transient heart block?
Smaller burrs at lower speeds
