Patients with coronary artery disease who are suitable candidates for coronary artery bypass graft surgery and who meet one of the following selection criteria may benefit from percutaneous rotational coronary angioplasty using the Rotablator Rotational Atherectomy System, either as the sole therapy or in conjunction with adjunctive balloon angioplasty.

Atherosclerotic coronary artery disease in a single vessel that can be passed by a guidewire; atherosclerotic coronary artery disease in multiple vessels that, in the doctor's opinion, does not put the patient at undue risk; atherosclerotic coronary artery disease in a native vessel that is less than 25 mm in length; or atherosclerotic coronary artery disease in some patients who have previously undergone PTCA.

 

Rotablator Rotaglide intended use/indications for its use:

The Rotaglide lubricant is designed to be used with the Rotablator atherectomy system in order to improve the system's lubricity.

 

Rotablator Rotalink Plus/ RotaWire and RotoWire Elite or Console contraindications

1. Obstacles that a guidewire cannot pass past.

2. The final vessel with impaired left ventricular performance.

3. Grafts from saphenous veins.

4. The presence of a thrombus on an angiogram before using the Rotablator System. Thrombolytics may be used to treat such people (e.g., Urokinase). The Rotablator System may be used to treat the lesion once the thrombus has been gone for two to four weeks.

5. Angiographic proof that the treatment site has had considerable dissection. Before using the Rotablator System to treat the lesion, the patient may receive conservative care for about four weeks to allow the dissection to heal.

Regardless of the therapeutic device being used, treating specific types and/or locations of lesions or patients with certain diseases is intrinsically risky. Only a small number of Rotablator System cases have been performed for several of these applications. Physicians treating such patients should be aware of the increased risk and the paucity of scientific support for treatment in the following situations:

• Patients with severe, diffuse three-vessel disease (several diseased vessels should be treated in different sessions); Patients who are not candidates for coronary artery bypass surgery;
• Patients with unprotected left main coronary artery disease, patients with an ejection fraction under 30%, patients with lesions larger than 25 mm, and patients with angulated ( 45°) lesions are within the group 3.

 

• Rotablator System percutaneous rotational angioplasty should only be performed at medical facilities with access to prompt emergency bypass surgery in the case of a potentially harmful or fatal complication.

• The patient must receive appropriate medication therapy throughout all stages of patient care, including but not limited to anticoagulant and vasodilator therapy.

• In order to correct any electrophysiological aberrations that may arise during the treatment of lesions in the right coronary and dominant circumflex arteries, a temporary pacing lead may be required.

• The brachial approach has not had much experience.

• The infusate must only be regular saline.

 

Patients with angina pectoris who have coronary heart disease can benefit from this operation. Plague, a fatty substance consisting of cholesterol, calcium, and other substances, tends to accumulate in the arteries over time. This results in a partial or complete blockage of that artery, which can cause a heart attack, a stroke, or pain-causing obstructions in the blood vessels in the legs. If the plaque is soft enough, a narrow tube with a tiny balloon at its end can be used to dissolve it quickly. An interventional cardiologist controls this device. The balloon is opened after the tube has been inserted into the artery to remove the plaque and to revive the artery so that blood flow is improved. The name of this procedure is angioplasty. Rotablation or rotational atherectomy is used when the plaque is too stubborn to be removed with angioplasty.

An angioplasty technique is performed to treat angina symptoms. In this procedure, a guide wire is inserted into a plaque-clogged cardiac artery to widen it again.

To push the plaque to the sides and enhance blood flow through this portion of the restricted artery, a tiny balloon is introduced along the wire and then inflated. After the balloon is removed, a metal mesh device known as a stent is frequently placed to keep the artery open.

Rotablation may be utilised occasionally when the plaque is exceptionally tough or is so narrow that the balloon cannot flow through it. The narrowing is once more navigated using a very fine wire.

Then, a special catheter (a thin tube) with an air-powered drill at its tip is introduced along the wire. In order to gradually broaden the narrowing, this drill is used to chip away at the plaque. Once this has been completed, a balloon can be introduced, and the angioplasty can continue as usual.

For the procedure, you will be awake. While the drill is not painful, it can be surprisingly noisy. However, similar to an angioplasty, you might experience a slight discomfort in your chest. The area in your groyne or wrist where the catheter is implanted is anaesthetized locally.

 

What conditions are treated with this procedure, and how it is done?

Long-term calcium buildup in the artery walls can result in the plaque becoming incredibly rigid and hard. Sometimes the plaque hardens and calcifies to the point where an angioplasty balloon cannot enlarge the artery. Medical experts developed the rotablator, a tiny gadget, to solve this issue. It also goes by the name "diamond rotor" since one of its ends has a burr covered in diamond dust. Balloon angioplasty is used to extend the region after the drill head has been inserted into the problematic artery. High pressure balloons are frequently used to help the stents fully expand. The placement of drug-eluting stents is the next step. To prevent recurrent arterial blockage, these stents gradually release a medication. Long-term therapeutic outcomes are ensured by doing this.

The hardened plaque is drilled through by the rotablator, which simultaneously shreds it into tiny fragments. Once safely ingested by the bloodstream, these tiny plaque fragments can then be safely removed by the body.