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Case Reports in Cardiology
Volume 2017 (2017), Article ID 2397183, 4 pages
https://doi.org/10.1155/2017/2397183
Case Report

Peeled Guidewire Coating with Debulked Plaque Obtained by Directional Coronary Atherectomy

Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, Japan

Correspondence should be addressed to Tsunekazu Kakuta

Received 8 February 2017; Accepted 28 March 2017; Published 5 April 2017

Academic Editor: Ertuğurul Ercan

Copyright © 2017 Rikuta Hamaya et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Percutaneous directional coronary atherectomy (DCA) is a plaque debulking method performed in Japan, and recently a renewed DCA device has been launched. We present a case with a tight left anterior descending lesion undergoing percutaneous coronary intervention with application of DCA. After several sessions of DCA, white plaques accompanied by green, stringed materials were obtained from the device; some materials were considerably long (approximately 15 mm in length). A drug-eluting stent was subsequently implanted, and the procedure was completed successfully without any complications. The extracted plaques and artificial materials were pathologically examined, and no inflammatory changes were detected on plaques adjacent to the material. Assessing pathological findings and structure of the DCA catheter, the obtained artificial materials were considered as peeled guidewire, possibly resulting from the friction between the guidewire and metallic bearing in the housing of DCA catheter. Of note, this phenomenon has been recognized even in other DCA cases in which guidewires of the other kind are used. We report this phenomenon for the first time, warning of theoretically possible distal embolization of artificial materials caused by any debulking devices.