Rotational Atherectomy

Overview

No Reviews

Credits

1.00

Post Assesment Questions

5

Release Date

5 Oct 2020

Expiration Date

7 Apr 2022

Last Reviewed

7 Apr 2021

Estimated Time To Finish

60 Minutes

Stay up to date on the latest medical knowledge

Start This Activity
 
Need Help?  If you have a system or content concerns, please contact support@statpearls.com

Activity Description

Coronary stenoses with circumferential or significant vessel calcification are rigid and frequently not dilatable with use of conventional balloon angioplasty. Often stent dilation and maximal vessel wall apposition are compromised in extensively calcified coronary lesions, stents deployed in heavily calcified vessels without atherectomy tend to thrombose, restenosis, and could cause stent fracture. Significant calcification remains a major limitation of balloon angioplasty as well as successful stent delivery to severely affected vessels. In cases with heavily calcified lesions, high-pressure, non-compliant balloon inflations may still fail to dilate adequately and prepare a heavily calcified vessel for stent delivery. This activity reviews the indications, contraindications, and complications of rotational atherectomy and highlights the role of the interprofessional team in the management of patients with CAD. Atherectomy refers to the removal of the obstructing material, and in our case this is calcium. By removing significant calcification or modifying the calcified atherosclerotic plaque vessel wall compliance in calcified or fibrotic lesions is increased, and the lumen diameter gained from using this device will be much improved as compared to the use of simple balloon angioplasty. Rotational atherectomy is one of several ways to perform atherectomy in a coronary vessel. It is the most commonly used atherectomy device and removes atheromatous plaque by differential cutting, that is removing the inelastic calcified plaque with microscopic (20 to 50 micrometers) diamond chips embedded on the surface of a rapidly rotating (150,000 to 200,000 rpm) olive-shaped burr. Such abrasion generates 2 to 5-micrometer microparticles that propagate through the coronary microcirculation and are removed by the reticuloendothelial system. The burr travels over a specialized 0.009-inch guidewire and is available in diameters ranging from 1.25 to 2.50 mm. In the setting of severe calcification, smaller burr sizes should be used initially, followed by larger burrs in 0.25 to 0.50-mm increments up to 70% of the reference vessel diameter. This activity describes rotational atherectomy, and explains the role of the interprofessional team in managing patients who undergo this procedure.

Activity Image

Target Audience

This activity has been designed to meet the educational needs of physicians.

Learning Objectives

At the conclusion of this activity, the learner will be better able to:

  • Describe the technique of rotational atherectomy.
  • Review the indications for rotational atherectomy.
  • Summarize the complications of rotational athetectomy.

Author(s) / Contributors Disclosure of Conflicts of Interest

Each author, editor, faculty and planning committee member have completed a disclosure form indicating that neither they nor their spouse/partner has a financial interest/arrangement or affiliation that could be perceived as a real or apparent conflict of interest related to the content of this activity.

COMMERCIAL SUPPORT: This activity has received NO commercial support.

Contributors

Hover over the contributor names to see details and disclosures of any financial relationships or relationships they or their spouse/life partner have with commercial interests related to the content of this continuing education activity.

Continuing Education Accreditation Information


This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Quillen College of Medicine, East Tennessee State University, and StatPearls, LLC. The Quillen College of Medicine, East Tennessee State University is accredited by the ACCME to provide continuing medical education for physicians.

Quillen College of Medicine, East Tennessee State University designates this activity for a maximum of 1.00 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Cancellation Policy: Cancellations must be received in writing and a money-back guarantee is provided if not completely satisfied.

  • StatPearls and ETSU reserve the right to cancel any course due to unforeseen circumstances. StatPearls and ETSU will not be responsible for other expenses incurred by the participant in the unlikely event that the program is canceled.

Equal Opportunity

  • StatPearls and ETSU are Equal Opportunity / Affirmative Action / Equal Access Institutions. 

Medium or Media Used:

  • Computer Requirements:  Internet Access
  • E-mail Address

Instructions for Credit

  1. Register for the activity and create a StatPearls login.     
  2. Review the required accreditation information:  Target audience, learning objectives, and disclosure information.
  3. Complete the entire self-study activity.
  4. Complete the post-test assessments.
  5. Successfully pass the post-test with a minimum score of 100%.
  6. Complete the evaluation survey. 
  7. Obtain a certificate.

StatPearls and ETSU adhere to ACCME Standards regarding commercial support of continuing medical education. It is the policy of StatPearls and ETSU that the faculty and planning committee disclose real or apparent conflicts of interest relating to the topics of this educational activity, that relevant conflict(s) of interest are resolved, and also that authors and editors will disclose any unlabeled/unapproved use of drug(s) or device(s) during their presentation. Detailed disclosure will be made prior to starting the activity.

The information provided at this CME/CE activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

  • If you need help with the system or have a question about content, please contact support@statpearls.com, or call 727-289-9796.
  • If you have a question about the ETSU CME providership, please contact wolfes1@etsu.edu.

 

Media Usage Rights

The contributors and editors of StatPearls have attested that all associated media (images and video) have been legally cleared for use with this activity.  All copyrights are reserved.

    Unlimited Physician CME

    Stay up to date on the latest medical knowledge with 6053 CME activities. In these online self-assessment activities, read our reference articles and test your knowledge with more than 6560.75 hours of CME.

    Single Activity

    Take this single activity

    $39 1 activity

    6 Month Unlimited Physician CME

    Access to all the Unlimited Physician CME activities in all specialties.

    $199 per half year per user

    1 Year Unlimited Physician CME

    Access to all the Unlimited Physician CME activities in all specialties.

    $299 per 1 year per user