Rotational Atherectomy Stuck Burr Retrieval, A Percutaneous Approach

Cardiovascular disease remains the leading cause of death worldwide. Besides conventional therapies to treat coronary artery disease, which ranges from preventative measures to invasive intervention, complex percutaneous coronary intervention techniques have been developed that yield several techniques including rotational atherectomy (RA). It is evident that RA has benefits primarily in treating calcific coronary artery lesions predominantly lesion modification. Similar to other invasive procedures, RA carries variable risks such as perforation, entrapped burr, slow-flow and dissection. Entrapped burr can lead to devastating complications, where it may end up by emergency surgery. The authors report a rare complication of RA, Kokeshi phenomenon, where the stuck burr was successfully retrieved percutaneously.