ROBITAL Atherectomy via 5-F Guide for Calcified Left Main Disease With Cardiogenic Shock.

Authors

Soleiman Aria, Su Hnin Hlaing, Darren L Walters, Rustem Dautov

Published in

JACC. Case reports. Pages 110355. Sep 23, 2026. Epub Sep 23, 2026.

Abstract

Sequential ROtational and orBITAL (ROBITAL) atherectomy combines sequential rotational and orbital atherectomy to manage complex coronary calcium. We report its feasibility using a 5-F guiding catheter in a patient with critical left main (LM) disease when larger guides could not achieve stable engagement.
An 83-year-old woman presented with cardiogenic shock, pulmonary edema, and severe calcified ostial/distal LM disease. After intra-aortic balloon pump insertion, only a 5-F JL 3.5 guide achieved coaxial engagement. ROBITAL atherectomy allowed adequate calcium modification, allowing intravascular ultrasound-guided percutaneous coronary intervention. She recovered fully and remained well 3 years later.
Limited literature supports 5-F calcium modification strategies. This case demonstrates ROBITAL atherectomy via a 5-F guide for unstable LM disease when larger guides failed to engage the LM.
ROBITAL atherectomy enables complex calcium modification through a 5-F guiding catheter, extending options for patients with only limited radial access and when larger guides cannot engage the coronaries.

PMID:
42776117
Bibliographic data and abstract were imported from PubMed on 23 Sep 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.