Structural degradation of a rotational atherectomy burr following treatment of a massively calcified coronary lesion: Insights from scanning electron microscopy.
P Barsoum, D Bazin, B Grine et al.
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Case in brief
A patient with a massively calcified coronary lesion underwent rotational atherectomy, but the burr failed to cross the lesion despite maintaining rotational speed. Examination revealed surface alterations on the burr, and replacing it allowed successful lesion crossing. Scanning electron microscopy showed significant thinning of the cobalt matrix and loss of diamond particles, indicating degradation as the cause of reduced performance.
Diagnostic / clinical pearl
Clinicians should be aware that degradation of the cobalt matrix in rotational atherectomy burrs can lead to reduced efficacy, necessitating burr replacement during procedures.
Why it matters
Understanding the structural degradation of atherectomy burrs can aid interventional cardiologists in recognizing when to replace the device, potentially improving procedural outcomes.