Successful Rotational Atherectomy for an Angulated Calcified Lesion in an Anomalous Right Coronary Artery Using the “Mother-and-Child” Technique

Percutaneous coronary intervention (PCI) involving the anomalous coronary artery is challenging with respect to difficulty in achieving stable catheterization. Rotational atherectomy (RA) can facilitate severely calcified lesions to improve stent delivery and stent expansion; however, its utility in tortuous and angulated coronary arteries is limited with difficulty in delivery of the RA burr. The mother-and-child technique is effective for complex PCIs with increased backup force for device delivery in such complicated cases. We report a case of successful rotational atherectomy using the "mother-and-child" technique with a Dio thrombus aspiration catheter for an angulated calcified lesion in an anomalous origin of the right coronary artery.