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Rotablation Wire Fracture During a Challenging Percutaneous Coronary Intervention
Stefanos Votsis1, Phong Nguyen2, Vishal Arora2
1Medical College of Georgia at Augusta University, Augusta, Georgia, USA; 424 Military Hospital, Thessaloniki, Greece.
JACC. Case Reports
|August 22, 2025
Summary
Rotablation wire fracture is a rare complication during coronary interventions for calcified lesions. Operators must be prepared for unexpected events and adapt their techniques to ensure successful patient outcomes.
Area of Science:
- Interventional Cardiology
- Cardiovascular Surgery
Background:
- Rotablation is a key technique for modifying calcified coronary lesions.
- Rotablation wires are engineered to withstand high pressures and temperatures.
Observation:
- A case report details a rotablation wire fracture during a procedure on a severely calcified right coronary artery.
- The wire fractured and became entrapped during the final run, requiring retrieval.
Findings:
- Rotablation wire fracture is an uncommon complication, with only two prior reported cases.
- Factors contributing to fracture include heavy calcification, complex anatomy, and wire fatigue.
Implications:
- Even specialized wires can fail, necessitating operator adaptability.
- Successful percutaneous coronary intervention was achieved despite the complication using intravascular ultrasound guidance.
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