Rotational atherectomy (Rotablation)
Chronic narrowing's or blockages may become calcified or have a lot of atheroma in them making them very difficult to treat with just a balloon.
Rotablation is a procedure where, once again, a very fine wire is guided through the narrowing and then a catheter with a small device called a burr, similar to drill, mounted at its tip is guided to the beginning of the narrowing.
The burr is connected to an external device which when activated by the cardiologist causes the burr to spin at very high speeds inside the narrowing, thereby creating a channel wide enough for a balloon or stent to then be used.