{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T06:08:51Z","timestamp":1778998131305,"version":"3.51.4"},"reference-count":18,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,7,6]],"date-time":"2025-07-06T00:00:00Z","timestamp":1751760000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,7,6]],"date-time":"2025-07-06T00:00:00Z","timestamp":1751760000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Rotational and orbital atherectomy are important tools to treat calcific coronary disease. Entrapment of an atherectomy device, that is, rotational atherectomy burr or orbital atherectomy crown, is a serious complication during atherectomy. Loss of an atherectomy device is a more challenging complication that usually follows device entrapment. Although uncommon, given the increased adoption of atherectomy, it is important for interventional cardiologist to understand the mechanisms and principles for prevention and management of lost atherectomy devices. Given the paucity of reported cases, there is no clear consensus or defined approach as to how this complication is best managed. The current recommendations for burr\/crown entrapment are generally to remove everything from the coronary vasculature and range from different percutaneous strategies and ultimately cardiac surgery. Conservative treatment with leaving the burr within the coronary vasculature has not been recommended. This article serves to review and provide a contemporary update on the management of lost atherectomy devices in the coronary arteries. We review the management and techniques centered around cases of lost atherectomy devices including a unique cohort of patients with lost burrs\/crowns that were left in the coronary arteries. Finally, we provide an algorithmic approach to the contemporary management of lost atherectomy devices, incorporating a conservative strategy arm, and discuss situations where this may be considered.<\/jats:p>","DOI":"10.1002\/ccd.31734","type":"journal-article","created":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T01:45:54Z","timestamp":1751852754000},"page":"1766-1780","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Management of Lost Atherectomy Devices in the Coronary Arteries"],"prefix":"10.1002","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0122-5397","authenticated-orcid":false,"given":"Gregor","family":"Leibundgut","sequence":"first","affiliation":[{"name":"Department of Cardiology University Hospital Basel Basel Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandru","family":"Achim","sequence":"additional","affiliation":[{"name":"Cardiology Department Heart Institute Cluj\u2010Napoca Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Weilenmann","sequence":"additional","affiliation":[{"name":"Ostschweizer Herzzentrum St. Gallen St. Gallen Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes","family":"Rigger","sequence":"additional","affiliation":[{"name":"Department of Cardiology Kantonsspital St. Gallen St. Gallen Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabian","family":"Gocht","sequence":"additional","affiliation":[{"name":"Innere Medizin II\/Kardiologie, Asklepios Klinik Nord\u2010Heidberg Hamburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3642-318X","authenticated-orcid":false,"given":"Mohaned","family":"Egred","sequence":"additional","affiliation":[{"name":"Department of Cardiology Freeman Hospital &amp; Newcastle University Newcastle upon Tyne UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bilal","family":"Murad","sequence":"additional","affiliation":[{"name":"Department of Cardiology Allina Health Minneapolis Heart Institute St. Paul Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Lombardi","sequence":"additional","affiliation":[{"name":"Department of Cardiology University of Washington Medical Centre Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Bilal Iqbal","sequence":"additional","affiliation":[{"name":"Department of Cardiology Royal Jubilee Hospital Victoria British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,6]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2013.12.196"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2012.07.017"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12928-017-0484-7"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0741-5214(88)90148-6"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/17434440.2017.1384695"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.4244\/eijv9i2a41"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.25270\/jic\/23.00174"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.5114\/pwki.2013.37516"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1155\/2024\/5482922"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ihjccr.2020.07.011"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.31496"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1510\/icvts.2010.238055"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.4244\/eijv7i10a197"},{"key":"e_1_2_7_15_1","unstructured":"EuroPCR. Coronary Stuck Burr (in or Beyond the Stenosis): Kokeshi Phenomenon. Europa Group. Accessed June 2019 https:\/\/www.pcronline.com\/Cases-resources-images\/Complications\/Implant-loss\/Coronary-embolised-devices\/Rotablator\/Stuck-burr."},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.1810220211"},{"key":"e_1_2_7_17_1","first-page":"230","article-title":"Triple Wire Technique for Removal of Fractured Angioplasty Guidewire","volume":"19","author":"Collins N.","year":"2007","journal-title":"The Journal of Invasive Cardiology"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/17434440.2017.1384695"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcr\/ytad311"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.31734","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccd.31734","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.31734","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T05:35:52Z","timestamp":1778996152000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.31734"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,6]]},"references-count":18,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1002\/ccd.31734"],"URL":"https:\/\/doi.org\/10.1002\/ccd.31734","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"value":"1522-1946","type":"print"},{"value":"1522-726X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,6]]},"assertion":[{"value":"2025-06-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}