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 present an overview of coronary rotational atherectomy for heavily calcified lesions. They explain how fluoroscopy and intravascular imaging identify calcium, and how a diamond-coated burr modifies plaque to facilitate stent delivery and expansion. The presenters review indications, limitations, and contraindications, including heavy thrombus, severe dissection or perforation, and certain graft lesions. They describe the Rotablator system, burr and guide sizing, flush preparation, and procedural precautions such as brief ablation runs, coordinated advancement, and monitoring rotational speed. The nursing and technical team’s roles include equipment setup, patient and hemodynamic monitoring, tracking burr speed and ablation time, and preparing for complications. Common challenges include slow flow, conduction disturbances, gas-supply problems, and burr entrapment. The presentation emphasizes team communication, careful patient selection, and readiness to troubleshoot to support safe, effective PCI.

Asset Subtitle

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

Asset Caption

closed captions are computer-generated

Keywords

coronary rotational atherectomy

calcified coronary lesions

Rotablator system

intravascular imaging

percutaneous coronary intervention

nursing team monitoring