Orbital atherectomy as an adjunct to debulk difficult calcified lesions prior to mesenteric artery stenting

Jesse M. Manunga, Gustavo S. Oderich

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Purpose: To describe a technique in which percutaneous orbital atherectomy is used to debulk heavily calcified superior mesenteric artery (SMA) occlusions as an adjunct in patients undergoing angioplasty and stenting. Technique: The technique is demonstrated in a 62-year-old woman with a replaced right hepatic artery originating from an SMA occluded by densely calcified lesions. Via a left transbrachial approach, a 7-F MPA guide catheter was used to engage the ostium of the SMA, which was crossed using a catheter and guidewire. The calcified lesion was debulked using the 2-mm Diamondback 360° orbital atherectomy system. The wire was exchanged for a 0.014-inch filter wire and 0.018-inch guidewire. Using a 2-guidewire technique, the SMA was stented with a self-expanding stent for the distal lesion that crossed side branches and a balloon-expandable stent at the ostium. A 0.014-inch guidewire was placed into the replaced hepatic artery through a cell of the self-expanding stent, followed by deployment of a small balloon-expandable stent to address the residual lesion. Conclusion: The use of orbital atherectomy to debulk occluded and heavily calcified SMA lesions may optimize the technical results with angioplasty and stenting.

Original languageEnglish (US)
Pages (from-to)489-494
Number of pages6
JournalJournal of Endovascular Therapy
Issue number4
StatePublished - Aug 28 2012


  • Calcification
  • Occlusion
  • Orbital atherectomy
  • Stent
  • Superior mesenteric artery

ASJC Scopus subject areas

  • Surgery
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


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