Basics of the Cath Lab: Resources for CVPs, Fellows, and the Cath Curious (Coronary Interventions 101)-Rotablation

Video Transcription

Video Summary

Dr. Huda and advanced nurse practitioner Derek Pineda review rotational atherectomy for treating severely calcified coronary lesions. Fluoroscopy can reveal radiopaque calcium, but IVUS or OCT is more sensitive. A diamond-coated burr modifies calcium to facilitate device delivery and improve stent expansion; burr size should be matched to vessel size, with conservative, brief runs to reduce complications.<br /><br />The presenters cover indications, contraindications, equipment, flush preparation, wire selection, and considerations such as temporary pacing for patients at risk of heart block. Safe performance depends on coordinated communication between operators and staff. Nurses and technicians prepare equipment and flush, monitor hemodynamics and burr speed, alert the operator to speed drops, and keep complication-management tools ready. Troubleshooting includes checking gas supply and connections if the burr will not spin, and addressing slow flow or hypotension. The central message is that careful preparation, teamwork, and monitoring are essential for effective, safe treatment.

Asset Subtitle

Amit Hooda, MD, FSCAI; Derek Pineda, FNP, CCRN, RCIS, AACC

Asset Caption

closed captions are computer-generated

Keywords

rotational atherectomy

coronary calcification

intravascular imaging

stent expansion

nursing teamwork

complication management