When the RotaWire Crosses but Cannot Advance: Dual‐Lumen Microcatheter–Assisted RotaWire Delivery
Year: 2026
Type: article
Study design: Case Report
Abstract: RotaWire delivery can be challenging in severely calcified device-uncrossable coronary lesions when conventional wire exchange through a microcatheter is not feasible. We report a 76-year-old man with a severely calcified mid-left anterior descending coronary artery (LAD) lesion in which neither a microcatheter nor a 0.75 mm balloon could cross. A second channel was created using a penetration wire through a dual-lumen microcatheter, allowing direct RotaWire crossing. However, the RotaWire could not be advanced sufficiently into the distal LAD. After intentional proximal pullback of the dual-lumen microcatheter, the microcatheter and RotaWire were held together and advanced as a single unit, enabling adequate distal RotaWire positioning and successful rotational atherectomy. This case highlights a distinct challenge after successful direct RotaWire crossing and demonstrates coupled advancement with a dual-lumen microcatheter as a potential bailout technique when distal RotaWire advancement remains difficult.
DOI: 10.1002/ccd.70998
Institutions: Miyazaki Prefectural NOBEOKA Hospital, Kumamoto University
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W7225396605