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Bilal Iqbal

@DrBIqbal1,234 subscribers

Interventional Cardiologist | Professor | Author | Complex PCI | CTO intervention | Medical Education | Boxing & MMA enthusiast

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An educational rota burr entrapment case. When a burr is stuck, we pull on the burr. If that doesn’t work, then we think of complex manoeuvres: cutting the burr, removing Teflon sheath, guide extensions, parallel wiring/ballooning and ping pong guides etc… But we often forget the simple stuff. The 0.014 tip of rotawire is larger than 0.009 shaft that contains the burr. This prevents distal vessel injury but can help retrieve a stuck burr. If wire is intact, bring wire back to burr, but this can only be done with brake defeat on (this is often forgotten!!!). Once the tip is at the burr, just pull! Works in many cases of stuck burr. Here a case of LAD rotablation. Unrecognised calcific distal LMS disease, led to burr advancement and entrapment. Tugging the burr didn’t help. So brake defeat on and then pull the rota wire. Burr came out. Then rewired with new rotawire and used same burr to finish the job. #Cardiology #cardiotwitter #PCI #complexPCI #rotablation #complications CanCTO EuroCTOClub Sanjog Kalra Dr. Bill Lombardi Darshan Doshi, MD, MS Kambis Mashayekhi Stéphane Rinfret, MD SM Mihajlo Kovacic 🫀📕/🔋🕹️ Pierfrancesco Agostoni Neisser M Gregor Leibundgut Allison Hall Elliot Smith Luiz Fernando Ybarra Rustem Dautov Abdul Mozid Mohammad Almutawa Basem Elbarouni jcspratt Tom Kaier Anja Øksnes Raja Hatem Lorenzo Azzalini jedicath աǟզǟʀ.ǟɦʍɛɖ Tsutomu Fujita MD Farouc Jaffer MD PhD Mohaned Egred Stefan Harb Edney Boston-Griffiths Amir Ravandi Dr Imran Hanif Hashmi Omer Goktekin MD Maksymilian Opolski Kalpa De Silva Kalaivani Mahadevan Faurie Benjamin Michael Megaly Ignacio J. Amat Alex Truesdell Ziad Ali Ricardo Santiago sharmainethiru Jack Hall Salman Arain Mauro Carlino yasser sadek Masahiko Ochiai MD, FACC Sarah Fairley Margaret McEntegart

Bilal Iqbal

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