Rotational atherectomy in sub-acute anterior stemi with cardiogenic shock

Rotational atherectomy (RA) is a proven technique to modify a heavily calcified coronary lesion if balloon angioplasty failed. RA is frequently avoided in ST-elevation myocardial infarction (STEMI) as it may increase the risk of slow or no-reflow. It is also considered to be relatively contraindicated in lesions with a visible thrombus, by its manu-facturer. Regardless, RA may be a life-saving procedure in cases where no other percuta-neous coronary intervention (PCI) technique is available to modify the lesion adequately. This case reports successful use of RA to facilitate dilation and stent delivery of a previously non-dilatable lesion in a patient with sub-acute anterior STEMI complicated by cardiogenic shock. © 2021 Islami et al.