Peeled Guidewire Coating with Debulked Plaque Obtained by Directional Coronary Atherectomy

Percutaneous directional coronary atherectomy (DCA) is a plaque debulking method performed in Japan, and recently a renewed DCA device has been launched. We present a case with a tight left anterior descending lesion undergoing percutaneous coronary intervention with application of DCA. After severa...

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Main Authors: Rikuta Hamaya, Taishi Yonetsu, Sadamitsu Ichijo, Makoto Araki, Tadashi Murai, Yoshihisa Kanaji, Eisuke Usui, Junji Matsuda, Masahiro Hoshino, Masahiro Hada, Takayuki Niida, Yoshinori Kanno, Tsunekazu Kakuta
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Case Reports in Cardiology
Online Access:http://dx.doi.org/10.1155/2017/2397183
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author Rikuta Hamaya
Taishi Yonetsu
Sadamitsu Ichijo
Makoto Araki
Tadashi Murai
Yoshihisa Kanaji
Eisuke Usui
Junji Matsuda
Masahiro Hoshino
Masahiro Hada
Takayuki Niida
Yoshinori Kanno
Tsunekazu Kakuta
author_facet Rikuta Hamaya
Taishi Yonetsu
Sadamitsu Ichijo
Makoto Araki
Tadashi Murai
Yoshihisa Kanaji
Eisuke Usui
Junji Matsuda
Masahiro Hoshino
Masahiro Hada
Takayuki Niida
Yoshinori Kanno
Tsunekazu Kakuta
author_sort Rikuta Hamaya
collection DOAJ
description Percutaneous directional coronary atherectomy (DCA) is a plaque debulking method performed in Japan, and recently a renewed DCA device has been launched. We present a case with a tight left anterior descending lesion undergoing percutaneous coronary intervention with application of DCA. After several sessions of DCA, white plaques accompanied by green, stringed materials were obtained from the device; some materials were considerably long (approximately 15 mm in length). A drug-eluting stent was subsequently implanted, and the procedure was completed successfully without any complications. The extracted plaques and artificial materials were pathologically examined, and no inflammatory changes were detected on plaques adjacent to the material. Assessing pathological findings and structure of the DCA catheter, the obtained artificial materials were considered as peeled guidewire, possibly resulting from the friction between the guidewire and metallic bearing in the housing of DCA catheter. Of note, this phenomenon has been recognized even in other DCA cases in which guidewires of the other kind are used. We report this phenomenon for the first time, warning of theoretically possible distal embolization of artificial materials caused by any debulking devices.
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language English
publishDate 2017-01-01
publisher Wiley
record_format Article
series Case Reports in Cardiology
spelling doaj-art-0ca1fff6d4e1415aa03778d19c33e01d2025-08-20T02:03:04ZengWileyCase Reports in Cardiology2090-64042090-64122017-01-01201710.1155/2017/23971832397183Peeled Guidewire Coating with Debulked Plaque Obtained by Directional Coronary AtherectomyRikuta Hamaya0Taishi Yonetsu1Sadamitsu Ichijo2Makoto Araki3Tadashi Murai4Yoshihisa Kanaji5Eisuke Usui6Junji Matsuda7Masahiro Hoshino8Masahiro Hada9Takayuki Niida10Yoshinori Kanno11Tsunekazu Kakuta12Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, JapanDivision of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, JapanDivision of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, JapanDivision of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, JapanDivision of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, JapanDivision of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, JapanDivision of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, JapanDivision of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, JapanDivision of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, JapanDivision of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, JapanDivision of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, JapanDivision of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, JapanDivision of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, JapanPercutaneous directional coronary atherectomy (DCA) is a plaque debulking method performed in Japan, and recently a renewed DCA device has been launched. We present a case with a tight left anterior descending lesion undergoing percutaneous coronary intervention with application of DCA. After several sessions of DCA, white plaques accompanied by green, stringed materials were obtained from the device; some materials were considerably long (approximately 15 mm in length). A drug-eluting stent was subsequently implanted, and the procedure was completed successfully without any complications. The extracted plaques and artificial materials were pathologically examined, and no inflammatory changes were detected on plaques adjacent to the material. Assessing pathological findings and structure of the DCA catheter, the obtained artificial materials were considered as peeled guidewire, possibly resulting from the friction between the guidewire and metallic bearing in the housing of DCA catheter. Of note, this phenomenon has been recognized even in other DCA cases in which guidewires of the other kind are used. We report this phenomenon for the first time, warning of theoretically possible distal embolization of artificial materials caused by any debulking devices.http://dx.doi.org/10.1155/2017/2397183
spellingShingle Rikuta Hamaya
Taishi Yonetsu
Sadamitsu Ichijo
Makoto Araki
Tadashi Murai
Yoshihisa Kanaji
Eisuke Usui
Junji Matsuda
Masahiro Hoshino
Masahiro Hada
Takayuki Niida
Yoshinori Kanno
Tsunekazu Kakuta
Peeled Guidewire Coating with Debulked Plaque Obtained by Directional Coronary Atherectomy
Case Reports in Cardiology
title Peeled Guidewire Coating with Debulked Plaque Obtained by Directional Coronary Atherectomy
title_full Peeled Guidewire Coating with Debulked Plaque Obtained by Directional Coronary Atherectomy
title_fullStr Peeled Guidewire Coating with Debulked Plaque Obtained by Directional Coronary Atherectomy
title_full_unstemmed Peeled Guidewire Coating with Debulked Plaque Obtained by Directional Coronary Atherectomy
title_short Peeled Guidewire Coating with Debulked Plaque Obtained by Directional Coronary Atherectomy
title_sort peeled guidewire coating with debulked plaque obtained by directional coronary atherectomy
url http://dx.doi.org/10.1155/2017/2397183
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