There’s no free lunch…😅 ROTAMONSTER

System setup: 8F AL1 / Guidezilla 8F / 1.5 burr / 200k RPM (planned for high speed Rotablation)

Fantastic case. Great save Evandro! Thanks for sharing. Couple of teaching points…..   1.        The driveshaft breakage is usually at the neck. That’s the weakest point on the driveshaft. Burr  detachment is almost always preceded by burr entrapment. The detachment occurs from the continuing spinning of the flexible coiled driveshaft, and the torsion forces weak and break the driveshaft at the neck. The pulling motion by the operator also facilitates detachment especially once the section has been weakened by the torsion forces.   2.        You have nicely demonstrated the advantage of the 0.014 Rota wire tip. As long as wire is intact, you will hopefully not get burr loss!!   3.        You do need really need a ping pong guide even with a primary 6F guide. If you cut the burr and remove the Teflon sheath, the drive shaft profile itself is very small, and you can accommodate parallel wires, MCs (TP LP and CorSair Pro XS) and even 2-5-4mm balloons in the same guide. Here with an 8 French guide you would have no issues at all. #PCI #rotablation #complexPCI #cardiology

@rotamonster I thought what a madlad trying to rotablate that low with such tortuosity of the RCA..and then I see there's also a stent there 😂 congrats on keeping your cool and solving the case with a great result!

Tough work and nice bailout procedure. Very far platform to rotablate the distal part.

It’s supposed to be my next step to get platform deeper but the driveshaft fractured very quick at the very first touch of dx lesion. I’m quite sure I didn’t stress the system too much. Maybe a device problem.

@rotamonster Every time you think you've seen everything, life has a way of humbling you. Nice save. There's a good reason why the tip of the rota wire has a larger diameter than the rest of the wire.

@rotamonster What a case! Nicely executed!!!!

@rotamonster Great save! You did very good atherectomy proximal to be able to pull that burr back

@rotamonster Yes Joaquim before retrieving I did extra preparation at the calcified bending with high pressure NC balloons for obvious reasons 😅

@rotamonster Very impressive save!! Thanks for sharing. We learn more from failures and complications than from straight forward cases. That being said, it takes a special person to share this with the world.