In some instances, the coronary narrowing can be particularly hard related to calcification of the furrings (atheroma) within the coronary artery. This may result in it being impossible to pass a balloon through the narrowing or precluding the balloon to adequately expand to facilitate stent implantation.
Prof Ruparelia may therefore recommend rotational atherectomy (Rotablation) to overcome this. After a special fine wire is passed through the narrowing, a special catheter is advanced with a tiny drill at its tip that is powered by compressed air. This drill is used to debulk the calcium and widen the narrowing through which conventional balloons can be inflated and stents implanted.
Prof Ruparelia shall explain the risks and benefits associated with the procedure.