Calcium is the arch-nemesis of the interventional cardiologist. The presence of calcium is a significant hindrance to delivering a stent to expand the blocked artery. Especially calcium located at the origin of an artery (also known as the ostium) poses an even bigger problem to the cardiologist as it is a very vulnerable location.

 

Rotablation uses a diamond-tipped burr which selectively cuts through calcium thereby paving the way to stent placement and expansion. However, calcium at the origin of an artery poses a bigger challenge to the cardiologist as it is a very critical location. One has to take extra care when using the rotablation at the origin of the artery to avoid any tears at the origin which can be disastrous to the patient.

 

This gentleman who had a critical right coronary artery narrowing with heavy calcification at the origin of the artery was a real challenge. The rotablator was used to cut the calcium at the origin with much caution and later stent delivery was a breeze!