GUIDEWIRE BIAS - POTENTIAL SOURCE OF COMPLICATIONS WITH ROTATIONAL ATHERECTOMY

The guidewire in rotational atherectomy is an integral component in th e ablative process. It functions not only to deliver the device but se ts the cutting vector when the burr advances. Since the guidewire is a stiff stainless steel monofilament and the vessels are frequently tor tuous and angulated, the guidewire may not be centrally oriented, but may bias preferentially to one side of the arterial wall. This may res ult in tangential or radial cutting. The following cases illustrate th e dependence of the ablative process on the lie of the guidewire and t he importance of integrating this factor in proper use of the Rotablat or system. (C) 1996 Wiley-Liss, Inc.