PMID- 21891819
OWN - NLM
STAT- MEDLINE
DCOM- 20120111
LR  - 20221207
IS  - 1557-2501 (Electronic)
IS  - 1042-3931 (Linking)
VI  - 23
IP  - 9
DP  - 2011 Sep
TI  - Desperate times, desperate measures: rotablating dissections in acute myocardial 
      infarction.
PG  - E226-8
AB  - The concomitant existence of an acute ST elevation myocardial infarction (STEMI) 
      and a truly undilatable lesion is not a common occurrence, although STEMI lesions 
      can be calcified and sometimes difficult to fracture. The manufacturer lists the 
      presence of a dissection as a contraindication to use for rotational atherectomy. 
      There are no previously reported cases in the literature of rotablation of 
      significant macro dissections in the setting of acute myocardial infarction (MI). 
      Noncompliant balloons, the Cutting Balloon Ultra (Boston Scientific), the Fx 
      miniRAIL (Abbott Vascular), and the "cutting wire" technique have all been 
      previously described for calcific lesion modification.1 Heavily calcific lesions 
      especially in the setting of a thrombotic infarction may predispose to under 
      expansion, restenosis, and stent thrombosis. Rotational atherectomy (RA) through 
      plaque ablation and altering arterial wall compliance may be helpful in 
      negotiating heavily calcific lesions.2 Previously, a single case report of the 
      use of RA in the setting of a STEMI has been reported.3 Two previous RA reports 
      have been de- scribed in the setting of acute and delayed healing of dissections; 
      however neither were in the setting of acute STEMI.4,5 We describe the first 
      report to our knowledge of RA for a truly undilatable lesion with accompanying 
      NHLBI type C iatrogenic dissection post balloon dilation during an acute STEMI to 
      allow lesion fracture and subsequent stent deployment.
FAU - Hussain, Farrukh
AU  - Hussain F
AD  - Interventional Cardiology, Department of Cardiology, St. Boniface General 
      Hospital, 409 Tache Avenue, Winnipeg, Manitoba, Canada. fhussain@sbgh.mb.ca.
FAU - Golian, Mehrdad
AU  - Golian M
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - J Invasive Cardiol
JT  - The Journal of invasive cardiology
JID - 8917477
RN  - 0 (Anticoagulants)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 9005-49-6 (Heparin)
RN  - A74586SNO7 (Clopidogrel)
RN  - OM90ZUW7M1 (Ticlopidine)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
MH  - Aged
MH  - Aortic Dissection/diagnosis/*etiology
MH  - Angioplasty, Balloon, Coronary/*instrumentation/methods
MH  - Anticoagulants/therapeutic use
MH  - Aspirin/therapeutic use
MH  - Atherectomy, Coronary/*adverse effects/instrumentation/methods
MH  - Clopidogrel
MH  - Female
MH  - Heparin/therapeutic use
MH  - Humans
MH  - Myocardial Infarction/drug therapy/pathology/*therapy
MH  - Platelet Aggregation Inhibitors/therapeutic use
MH  - Ticlopidine/analogs & derivatives/therapeutic use
EDAT- 2011/09/06 06:00
MHDA- 2012/01/12 06:00
CRDT- 2011/09/06 06:00
PHST- 2011/09/06 06:00 [entrez]
PHST- 2011/09/06 06:00 [pubmed]
PHST- 2012/01/12 06:00 [medline]
PST - ppublish
SO  - J Invasive Cardiol. 2011 Sep;23(9):E226-8.