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Guide Tip Damage Due to Rotablation
Satoshi Taya1, Masatoki Yoshida2, Kentaro Ejiri2
1Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan.
Insights
Rotational atherectomy for calcified coronary lesions can cause rare guide catheter fractures. Careful positioning and technique, especially in the right coronary artery ostium, may prevent this complication.
Area of Science:
- Cardiovascular Interventions
- Interventional Cardiology
Background:
- Rotational atherectomy is effective for calcified coronary lesions.
- Rare complications, including guide catheter fracture, have been reported.
Background:
The rotational atherectomy system can effectively debulk calcified coronary lesions. However, rare complications specific to that system have been reported.
Case Summary:
A 77-year-old man with a heavily calcified lesion in the right coronary artery (RCA) ostium underwent percutaneous coronary intervention in an 8-F system. During the procedure, rotablation with a 2.25-mm burr was required. After the percutaneous coronary intervention, partial loss of the tip of the guide was observed. He had no clinical sequelae despite the presumed retained catheter material in his body.
Discussion:
Although insufficient guide coaxiality has been suggested as the primary cause of guide tip fracture during RCA ostial ablation, other factors may have contributed: the application of force to the tip and a small difference in size between the guide and the burr.
Take-Home Message:
When ablating RCA ostial lesions, positioning the burr platform outside the guide may help prevent similar complications in future cases.
