Fu Wai Hospital Uses Atherectomy and Stenting to Open CTO with Severe Calcification in 74-Year-Old Patient

In the field of interventional cardiology, Chronic Total Occlusion (CTO) combined with severe diffuse calcification is recognized as the most formidable "dual challenge." Dubbed the "ceiling level" difficulty, the calcified plaque forms a "stone wall" inside the vessel, making it nearly impossible for conventional interventional devices to pass.

Recently, Dr. Yang Honghui, Director of Coronary Artery Disease Ward 4 at Fu Wai Hospital, led his interventional team to successfully perform a high-difficulty Rotational Atherectomy (RA) + precise Stent Implantation for a 74-year-old patient suffering from triple-vessel disease, CTO, and severe calcification. The procedure pulled the patient back from the imminent threat of Acute Myocardial Infarction (MI).

The patient, Mr. Yang (74), was referred to Fu Wai Hospital due to severe angina and dyspnea over the past year. Angiography revealed complex coronary anatomy, including a CTO, and extensive, dense diffuse calcification lining the vessel walls—a scenario local hospitals deemed too risky to manage.

Technical Breakthrough: Carving a Path of Life Through "Stone" Facing the extreme challenge—where the guidewire failed to penetrate the calcification in the antegrade approach and the retrograde path was blocked by complex anatomy—Dr. Yang Honghui’s team meticulously planned and opted for the "Atherectomy + Precise Stenting" strategy:

• Rotational Atherectomy (RA): The team deployed a high-speed rotating burr to precisely "grind" the hardened calcified plaque into fine particles. This required exceptional dexterity and control, likened to "carving a path through stone."
• Precision Recanalization and Reconstruction: Once the pathway was successfully opened via RA, the team meticulously delivered and deployed the final stent, achieving complete recanalization and reconstruction of the occluded vessel.

The successful revascularization immediately restored blood flow, resolving the patient's year-long symptoms of chest tightness and shortness of breath. The patient recovered rapidly post-procedure and was safely discharged.

Dr. Yang Honghui emphasized that the success of such high-difficulty cases is the result of a combination of advanced technology, extensive experience, and efficient multidisciplinary cooperation. The seamless collaboration among Cardiology, Anesthesia, Imaging, Ultrasound, and the Cath Lab team is an indispensable "winning factor" in conquering complex CTO and calcified lesions. This case reinforces Fu Wai Hospital’s hardcore strength and leading position in complex, high-risk cardiovascular interventions.