Balloon rupture (BR) is an infrequent complication of percutaneous coronary intervention (PCI) and can lead to vessel injury. The present article describes a case in which PCI for a lesion that did not appear to be severely calcified on angiography was complicated by BR during stent postdilation. Balloon rupture went unrecognized, with resultant coronary dissection. The presence of sharp calcium spicules – which could not be detected by angiography – is highlighted as the likely cause of BR. Vigilance for BR during every step of PCI, particularly in calcified lesions, is also emphasized along with the need for prompt recognition of BR to avoid or minimize coronary wall trauma.
