Successful Percutaneous Rescue of an Entrapped Rotablator Burr With a Previously Implanted Stent: A Rare and Challenging Case of En Bloc Extraction of Stent, Burr, and Guidewire

Rotational atherectomy is an indispensable adjunct to percutaneous coronary intervention for heavily calcified coronary lesions, but it carries specific procedural risks. Among these, burr entrapment is rare but potentially catastrophic and often necessitates emergent surgical removal. We report the case of a 58-year-old man in whom a Rota burr became entrapped after engaging the struts of a previously implanted stent, resulting in a complex burr-stent-wire entrapment within the left anterior descending artery. A fully percutaneous bailout strategy was successfully performed using repeated balloon dilatations to disengage the deformed stent from the vessel wall, enabling en bloc retrieval of the burr-stent system without the need for surgical intervention. The patient was discharged as planned without complications. This case underscores that, even in the setting of a potentially catastrophic burr entrapment, meticulous percutaneous techniques can achieve complete device retrieval and obviate the need for emergent surgery, highlighting the importance of technical versatility and prompt decision-making in complex coronary interventions.