Impella-Supported Optical Coherence Tomography-Guided Aggressive Rotational Atherectomy for Heavily Calcified Lesions in Left Main Trunk Bifurcation in a Patient with Severe Left Ventricular Systolic Dysfunction

Figure 2

Impella-supported OCT-guided rotational atherectomy for LMT bifurcation lesion. The heavy calcification at the bifurcation of the left main coronary artery was visible on fluoroscopy (a). Coronary angiography before PCI (b and c). Rotational atherectomy with a 1.5-mm RotaPRO™ was performed from the LMT to the proximal LAD artery (d) and proximal left circumflex artery (LCx) (j). OFDI images pulled back from LAD (e–i). Then, additional atherectomy was performed from the LMT to the proximal LCx (k) and LAD (l) using a 2.0-mm RotaPRO™, and the lesions were again observed by OFDI, confirming that the calcified plaque had sufficiently reduced in volume (m–r).

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