A rare, unreported complication during coronary rotational atherectomy

We describe a rare and unreported complication during rotational atherectomy of a heavily calcified lesion in the left circumflex artery in a 79-year-old man. The Teflon sheath housing the drive shaft fractured, most probably due to overtightening of the Y-adapter hemostatic valve. As a result, there was intense spasm leading to acute ischemia and the procedure had to be abandoned. This case highlights the importance of using familiar and thoroughly tested hardware in technique-intensive procedures.