Rotational atherectomy of critical left main stenosis in NSTE-ACS complicated with cardiogenic shock

We report the case of a patient with acute anterolateral myocardial infarction without ST segment elevations and incipient cardiogenic shock due to complex high grade left main (LM) stenosis and tight calcified ostial left anterior descending (LAD) artery stenosis. Rotablation followed by stent deployment achieved a successful angiographic outcome with no associated clinical complications. During 30 days follow-up, the patient remains stable. An acute interventional approach in unprotected LM coronary stenosis is associated with high procedural risk. Combining that procedure, i.e., rotational atherectomy, with stent placement enhanced procedural success and clinical outcome in this case.