OCCURRENCE OF SLOW FLOW/NO REFLOW COMPLICATION DURING ROTATIONAL ATHERECTOMY: A REVIEW

Dhiraj Khati* and Yang Shaning

ABSTRACT

Percutaneous coronary intervention (PCI) is most common form of revascularization of symptomatic coronary artery disease in modern age. There are increased chances of calcified coronary disease in elderly, diabetic and renal patients, so rotational atherectomy (RA) can be useful in such kind of calcified lesions. Rotational atherectomy is a technique where calcified lesions are debunked with the high speed rotating burr. Along with many other complications slow flow/no reflow is also a main complication of this procedure. In initial days these complications were reported at large thus decrease in the usage of this technique but with the improvement of technique, usage of pharmacological flush, glycoprotein and drug eluting stents reported decrease in complications and rise of this technique once again while treating calcified lesions. The objective of this study is to know the average occurrence of this complication in difference studies conducted in different settings. Relevant studies and articles were reviewed, analyzed and we came to the conclusion that the complication of slow flow/no reflow is generally low below 2.6 % when following recent treatment techniques and using pre-, intra- and post-procedural pharmacological flush of heparin, nitroglycerine, vasodilator, glycoprotein IIb/IIIb and applying drug eluting stents after procedure.

Keywords: Rotational Atherectomy, Slow Flow, no Reflow, Rotablation.