Guide wire fracture with retained filament in the LAD and aorta

Abstract

Complete fracture of coronary guide wires during PCI is a very rare event usually associated with debulking devices [ 1 Cafri C. Rosenstein G. Ilia R. Fracture of a coronary guidewire during graft thrombectomy with the X-sizer device. J Invasive Cardiol. 2004; 16: 263-265 PubMed Google Scholar , 2 Woodfield S.L. Lopez A. Heuser R.R. Fracture of coronary guidewire during rotational atherectomy with coronary perforation and tamponade. Cathet Cardiovasc Diagn. 1998; 44: 220-223 Crossref PubMed Scopus (34) Google Scholar , 3 Vrolix M. Vanhaecke J. Piessens J. De Geest H. An unusual case of guide wire fracture during percutaneous transluminal coronary angioplasty. Cathet Cardiovasc Diagn. 1988; 15: 99-102 Crossref PubMed Scopus (30) Google Scholar , 4 Stellin G. Ramondo A. Bortolotti U. Guidewire fracture: an unusual complication of percutaneous transluminal coronary angioplasty. Int J Cardiol. 1987; 17: 339-342 Abstract Full Text PDF PubMed Scopus (23) Google Scholar , 5 Khonsari S. Livermore J. Mahrer P. Magnusson P. Fracture and dislodgment of floppy guidewire during percutaneous transluminal coronary angioplasty. Am J Cardiol. 1986; 58: 855-856 Abstract Full Text PDF PubMed Scopus (37) Google Scholar , 6 Foster-Smith K. Garratt K.N. Holmes Jr., D.R. Guidewire transection during rotational coronary atherectomy due to guide catheter dislodgement and wire kinking. Cathet Cardiovasc Diagn. 1995; 35: 224-227 Crossref PubMed Scopus (22) Google Scholar ]. Theoretically, guide wire remnants could lead to complications such as thrombosis, embolic phenomena and vessel occlusion. Whilst most authors recommend surgical extraction if percutaneous retrieval fails, there have been rare reports of wire fragments being left in situ without any adverse outcomes [ 1 Cafri C. Rosenstein G. Ilia R. Fracture of a coronary guidewire during graft thrombectomy with the X-sizer device. J Invasive Cardiol. 2004; 16: 263-265 PubMed Google Scholar , 7 Doorey A.J. Stillabower M. Fractured and retained guide-wire fragment during coronary angioplasty–unforeseen late sequelae. Cathet Cardiovasc Diagn. 1990; 20: 238-240 Crossref PubMed Scopus (27) Google Scholar , 8 Lotan C. Hasin Y. Stone D. et al. Guide wire entrapment during PTCA: a potentially dangerous complication. Cathet Cardiovasc Diagn. 1987; 13: 309-312 Crossref PubMed Scopus (28) Google Scholar , 9 Hartzler G.O. Rutherford B.D. McConahay D.R. Retained percutaneous transluminal coronary angioplasty equipment components and their management. Am J Cardiol. 1987; 60: 1260-1264 Abstract Full Text PDF PubMed Scopus (121) Google Scholar , 10 Chang TM, Pellegrini D, Ostrovsky A, Marrangoni AG. Surgical management of entrapped percutaneous transluminal coronary angioplasty hardware. 2002;29(4):329–32. Google Scholar ].