Entrapment of Rotational Atherectomy Burrs in Freshly Implanted Stents: First Illustration of the Rolled-Up Phenomenon.

OBJECTIVES: We aimed to illustrate one of the mechanisms of rotational atherectomy burr entrapment in a coronary stent where the burr was rolled up in the stent's struts.

METHODS: We report a case where the treatment of a mid right coronary artery (RCA) lesion using a rotational atherectomy device was attempted. During the procedure, the burr suddenly got stuck in a freshly implanted stent in the distal RCA. Despite several attempts and maneuvers, we were unable to pull back the burr.

RESULTS: The patient was transferred for emergency surgery. The length of the RCA from its proximal third to the crux, including the stuck burr and the freshly implanted stent, had to be extracted.

CONCLUSIONS: Physicians performing rotational atherectomy should be aware of this complication and know the principal endovascular maneuvers to extract the stuck burr. Operators should also be aware of roll-up burr entrapment, like this case, where most maneuvers to retrieve the burr will fail and should be managed, to our point of view, with surgery.