Successful surgical removal of an entrapped intravascular ultrasonography catheter in the left circumflex coronary artery

Abstract

Entrapment of an intravascular ultrasonography (IVUS) catheter is an infrequent but serious complication associated with percutaneous coronary intervention (PCI). A 67-year-old man who presented with exertional chest pain had an angiographic finding of 99 % stenosis of left circumflex coronary artery. PCI with stent implantation was performed successfully with an assessment by IVUS showing adequate stent expansion and apposition. When the IVUS catheter was retracted, it became trapped at the stent strut. The stent was deformed and the IVUS catheter became stuck there. Ventricular fibrillation suddenly occurred with deterioration of the coronary flow. He was transferred to the operating room just after insertion of intra-aortic balloon pumping. The IVUS catheter, the guidewire, and the deformed stent were all removed under cardiopulmonary bypass. Coronary artery bypass graft with a saphenous vein was also performed at the more distal segment from the entrapment site. The postoperative course was uneventful with no graft occlusion.