Technical Considerations in Transradial Unprotected Left Main Stem Rotational Atherectomy-Assisted and IVUS-Guided Percutaneous Coronary Intervention Using the 7.5F Eaucath Sheathless Guiding Catheter System

Rotational atherectomy-assisted percutaneous coronary intervention (PCI) on unprotected left main stem (LMS) bifurcation lesions is technically challenging. Intravascular ultrasound (IVUS) has become a standard part of the PCI procedure for the treatment of LMS disease. There is limited experience in performing these cases via a transradial approach using a sheathless guiding catheter (SGC) system. We report a case of a symptomatic octogenarian patient with restrictive angina and significant LMS bifurcation disease, who was successfully treated transradially with the use of the 7.5F Eaucath SGC system and we describe the technical challenges encountered with this strategy.