CLINICAL AND POSTMORTEM OUTCOME OF NO-REFLOW PHENOMENON IN A PATIENT TREATED WITH ROTATIONAL ATHERECTOMY

In the 77-year-old woman described, atherectomy of a circumflex artery with the Rotablator device was complicated by ''no reflow.'' Ten days later, a 75% right coronary artery stenosis was successfully managed by balloon angioplasty. On the following day, acute closure of this ve ssel resulted in death. Gross examination of the heart showed features of recent posterior infarction, and microscopic study revealed athero emboli in myocardial arterioles. We conclude that high-speed pulveriza tion of atherosclerotic plaque can cause clinically significant emboli .