19.3 Orbital atherectomy: Manual of PCI

Step-by-step description of orbital atherectomy:
Preparation:
1. Pacemaker needed?
2. Hemodynamic support needed?
Orbital atherectomy steps:
1. Engage target vessel
2. Wiring
3. Vasodilator
4. Test device
5. Advance crown proximal to lesion
6. Perform orbital atherectomy
7. Remove crown
8. Check angiographic result
9. Replace Viperwire with workhorse guidewire
10. Balloon angioplasty

[@shangz0216]

Thanks for your educative presentation.

[@Docsammy]

Great presentation. At our facility we save a few bucks by exchanging the workhorse wire with an over the wire balloon ( if crossable). Usually parallel wire with a workhorse wire after atherectomy.

[@manosbrilakis]

Great point - this works well too if the lesion is easy to cross.

[@areenal-taie6836]

Many thanks Dr Brilkais

[@svijaykumarreddy1242]

Nice description