Complication: Trapped Burr

  • Lucky R. Cuenza
  • Aaron Wong
  • Kay Woon HoEmail author
Part of the Clinical Cases in Interventional Cardiology book series (CCIC)


A 74-year-old former smoker and hypertensive male with aortic aneurysm was scheduled electively for endovascular aortic aneurysm repair (EVAR). He has been experiencing recurrent angina symptoms despite medical therapy. Echocardiogram showed an ejection fraction of 72% with no regional wall motion abnormalities. Coronary angiogram showed significant two-vessel disease in the left anterior descending artery (LAD) and a calcified lesion in the right coronary artery (RCA) (Fig. 22.1). Patient was then scheduled for multivessel PCI.

Supplementary material

Video 22.1

The burr 2.15-mm burr is trapped after two runs during the rotablation procedure (MOV 10770 kb)

Video 22.2

Cine image showing the burr stuck in the calcified plaque of the mid-right coronary artery (MOV 4125 kb)

Video 22.3

Applying the child in mother technique and pulling back on the Rotablator while countertraction is applied on the catheter (MOV 11431 kb)

Video 22.4

Successful percutaneous retrieval of the Rotablator burr after careful and continuous manual traction (MOV 7825 kb)


  1. 1.
    Yokoi H, Nishiyama K, Andou K, Nakanishi M, Abe K, Sakai T, et al. A discussion of trapped rotablator cases. Jpn J Interv Cardiol. 1999;14:MC 009.Google Scholar
  2. 2.
    Lin CP, Wang JH, Lee W, Ku P, Yin W, Tsao TP, et al. Mechanism and management of burr entrapment: a nightmare of interventional cardiologists. J Geriatr Cardiol. 2013;10:230–4.PubMedPubMedCentralGoogle Scholar
  3. 3.
    Hyogo M, Inoue N, Nakamura R, Tokura T, Matsuo A, Inoue K, et al. Usefulness of conquest guidewire for retrieval of an entrapped rotablator burr. Catheter Cardiovasc Interv. 2004;63(4):469–72.CrossRefPubMedGoogle Scholar
  4. 4.
    Prasan AM, Patel M, Pitney MR, Jepson NS. Disassembly of a rotablator: getting out of a trap. Catheter Cardiovasc Interv. 2003;59:463–5.CrossRefPubMedGoogle Scholar
  5. 5.
    Kimura M, Shiraishi J, Kohno Y. Successful retrieval of an entrapped rotablator burr using 5 Fr guiding catheter. Catheter Cardiovasc Interv. 2011;78:558–64.CrossRefPubMedGoogle Scholar
  6. 6.
    Cunnington M, Egred M. Guideliner, a child-in-mother catheter for successful retrieval of an entrapped rotablator burr. Catheter Cardiovasc Interv. 2012;79:271–3.CrossRefPubMedGoogle Scholar
  7. 7.
    Sulimov DS, Abdel-Wahab M, Toelg R, Kassner G, Geist V, Richardt G. Stuck rotablator: the nightmare of rotational atherectomy. EuroIntervention. 2013;9(2):251–8. Scholar
  8. 8.
    De Vroey F, Velavan P, El Jack S, Webster M. How should I treat an entrapped rotational atherectomy burr? EuroIntervention. 2012;12:1238–44.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Department of CardiologyNational Heart Centre SingaporeSingaporeSingapore

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