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Cutting Balloon Blade Fracture in Severe Calcified Lesions During Percutaneous Coronary Intervention

Dai Kawauchi1, Kei Yunoki1, Tomohiro Yoshino1

  • 1Department of Cardiology, Tsuyama Chuo Hospital, Okayama, Japan.

JACC. Case Reports
|June 20, 2025
PubMed

Insights

Cutting balloon (CB) blade fracture during percutaneous coronary intervention is rare. Lesion characteristics and repeated dilations may precipitate this complication, requiring interventionalist awareness.

Area of Science:

  • Interventional Cardiology
  • Medical Device Complications

Background:

  • Cutting balloon (CB) use is associated with rare but serious complications like blade fracture.
  • Understanding factors precipitating CB blade fracture remains limited.

Observation:

  • Three cases of CB blade fracture during percutaneous coronary intervention are presented.
  • Fracture occurred during dilation of calcified lesions, with repeated low- to high-pressure dilations or balloon entrapment noted.
  • Despite fracture, no severe coronary dissections or perforations were observed.

Findings:

  • CB blade fracture can be linked to high-pressure dilation of calcified lesions.
  • Repeated balloon dilations and specific lesion properties (circumferential, eccentric calcification) may contribute to fracture.
  • The dog-bone balloon shape was observed in cases involving repeated dilations.

Implications:

  • Interventional cardiologists must recognize the risk of CB blade fracture with calcified lesions.
  • Careful consideration of lesion characteristics and dilation strategy is crucial when using cutting balloons.
  • Awareness of this complication can guide preventative measures during percutaneous coronary intervention.
Abstract

Keywords:
blade fracturecoronary calcificationcutting balloonpercutaneous coronary intervention

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