Distal protection device in entrapped rota ablation burr – A basket of delight

Abstract Background Rota ablation is the one of the mainstay of treatment in patients with significant calcified lesions. The technique is associated with several complications of which, entrapment of rota ablation burr is the most dreadful. Case summary A 61 years old male with Diabetes Mellitus Type 2 presented with Unstable angina, Coronary angiography revealed single vessel disease with tortuous Mid RCA -70-80% lesion and heavy calcification. The patient was planned for a Rota atherectomy with stenting to mid RCA. During the rota ablation the burr got stuck into the calcified lesion, various documented techniques for retrieval of the burr were attempted but all were in vain, subsequently the shaft broke at the junction of the burr and shaft, leaving the burr stuck into the vessel. Finally a distal protection device was used to retrieve the stuck burr. It is the first case reported for use of distal protection device for retrieval for stuck rotablation burr. Discussion Various bailout strategies have been described in literature for such an event. The use of device protection device has not been mentioned as one of the methods. Herein we report a case with the use of distal protection device as a method for retrieval of entrapped rota ablation burr.