A CASE OF FAVORABLE DILATION OF PROTECTED LEFT MAIN CORONARY-ARTERY LESION ACHIEVED THROUGH PERFORMANCE OF ADJUNCTIVE DCA ON RESIDUAL STENOSIS FOLLOWING USE OF ROTABLATOR

It is believed that directional coronary atherectomy (DCA) is more sui table than percutaneous transluminal coronary angioplasty for lesions such as severe eccentric lesions, ostial lesions, and branch lesions. However, it remains a fact that lesions that are also highly calcified are often suboptimal, since there may be difficulties such as in inse rtion of the housing and in sufficient cutting and removal. On the oth er hand, Rotablator is effective on calcified lesions, but afterward, dilation by balloon angioplasty for residual stenosis becomes necessar y in many cases. This is a report of the authors' experience on an int eresting case in which favorable dilation of a lesion in the protected left main coronary artery (LMCA) was achieved by using Rotablator aft er confirmation of a high degree of calcification by means of intravas cular ultrasound (IVUS) echocardiograhy, followed by the performance o f DCA on the residual stenosis.