Open surgery retrieval of a missing guidewire causing cerebral infarctions after cerebral angiography: a case report

Chaodi Luo,Yang Yan,Dan Han,Jing Li

doi:10.1186/s13019-021-01531-w

Abstract

BackgroundIntra-aortic foreign body (IAFB) is uncommon, which is usually caused by a rupture of the catheter or guidewire. IAFB can cause catastrophic complications, including arrhythmia, embolization of guidewire fragments, intravascular clipping of the guidewire and vascular perforation. However, there are still no guidelines on removal and management of IAFB. Here, we present a rare case of fractured cerebral angiographic guidewires in the aorta that resulted in multiple cerebral infarctions.Case presentationA 50-year-old man experienced new cerebral infarction after cerebral angiography. Computed tomography and echocardiography demonstrated foreign bodies in his ascending aorta and aortic arch. Open surgery was successfully performed to retrieve the guidewires. The postoperation and follow-up was uneventful.ConclusionIt is very important for interventional radiologists to check the catheter and guidewire after operation and perform ultrasound or radiograph to prevent IAFB. Additionally, the effective management of IAFB requires the early detection and the selection of appropriate treatment options, as well as long-time follow up.

Highlights

It is very important for interventional radiologists to check the catheter and guidewire after operation and perform ultrasound or radiograph to prevent Intra-aortic foreign body (IAFB)
With the expanding application of catheters and the implementation of invasive procedures, interventional radiologists are increasingly faced with foreign body retention or iatrogenic placement of equipment, such as fractured guidewires or catheters
Infrequent incident can occur when resistance is encountered during removal, the guidewires are usually cut at the skin surface and retained in the vessel, which may cause catastrophic complications, including arrhythmia, embolization of guidewire fragments, intravascular clipping of the guidewire and vascular perforation [1,2,3,4]

Summary

Conclusion

With the rapid development of invasive procedures, IAFB is becoming more and more common. It is very important for interventional radiologists to check the catheter and guidewire after operation and perform ultrasound or radiograph to prevent such complications. The effective management of IAFB requires the early detection and the selection of appropriate treatment options, as well as long-time follow up, which are critical to the patient’s prognosis

Introduction

Discussion