Balloon inflation-assisted trapping and successful retrieval of partially fractured and entrapped guidewire

Abstract

Guidewire fracture (either partial or complete) is an exceedingly rare complication of which is mostly encountered in percutaneous coronary intervention (PCI) of complex lesions. It can be managed mostly with using percutaneous techniques, but at times requires a surgical approach as well. Here, we report a case of a 67-year-old male who underwent PCI of totally occluded proximal left anterior descending artery. Due to excessive manipulation, tip of Sion blue wire (polymer-jacket guidewire) got trapped into the lesion. To unloop the wire, spring tip got partially fractured. The guiding catheter was pushed over the fractured wire near the fracture point and a 2.5 mm × 10 mm Sapphire semi-compliant balloon (Orbus Neisch, Netherland) was inflated near the tip of guiding catheter at 12 atm pressure, and whole assembly was pulled out to successfully retrieve the partially fractured and retained wire.