Guidewire Entrapment Research Articles

Guidewire Entrapment in a Greenfield IVC Filter:‘Rail and Reins Technique’: Technical Report

Liddell, R. P. (2000). Clinical Radiology55, 878–881.

Guidewire entrapment during deployment of the over- the-guidewire stainless steel Greenfield filter: A device design-related complication

The Greenfield filter (Medi-tech/Boston Scientific, Watertown, Mass) is widely used for the prevention of pulmonary embolism. The latest version is a stainless steel over-the-wire filter. The purpose of the guidewire is to facilitate placement of the device down through the atrium or through tortuous vessels and to prevent tilting of the released filter. A case of entrapment of the guidewire in the filter after deployment through the right internal jugular approach and its recovery by reentering it into the sheath is presented. To prevent this complication, the guidewire should be removed completely before releasing this type of filter. The potential risk of tilting the filter does not outweigh the risk of guidewire entrapment.

Guidewire entrapment during deployment of the over-the-guidewire stainless steel Greenfield filter: A device design-related complication

The Greenfield filter (Medi-tech/Boston Scientific, Watertown, Mass) is widely used for the prevention of pulmonary embolism. The latest version is a stainless steel over-the-wire filter. The purpose of the guidewire is to facilitate placement of the device down through the atrium or through tortuous vessels and to prevent tilting of the released filter. A case of entrapment of the guidewire in the filter after deployment through the right internal jugular approach and its recovery by reentering it into the sheath is presented. To prevent this complication, the guidewire should be removed completely before releasing this type of filter. The potential risk of tilting the filter does not outweigh the risk of guidewire entrapment.

Entrapment of an exchange wire by an inferior vena caval filter: a technique for removal

The anesthesiology literature does not describe entrapment of a guidewire by an inferior vena caval filter. Because anesthesiologists are involved in central access in various perioperative and intraoperative settings, consideration of this complication is important. A case of guidewire entrapment by an inferior vena caval filter and a unique technique for removal of the entrapped wire is presented.

Guidewire entrapment during Greenfield filter deployment

Prevention of pulmonary embolism by inferior vena cava filter has long been established . The Greenfield filter continues to be modified to improve deployment methods. A new filter design allows insertion through tortuous anatomy. We present, by way of a case report, a unique complication related to this design. The filter design, deployment technique, and the rationale behind them are discussed. Suggestions for avoiding this problem are provided. (J Vasc Surg 1998;27:174-6.)

Safety of intracoronary ultrasound: data from a Multicenter European Registry.

The clinical use of intracoronary ultrasound imaging is growing, serving as a useful adjuvant to contrast angiography, and providing additional information to assist with catheter-based interventions. Despite the increasing use of this technique, it remains an invasive procedure, the safety of which has not been definitively established. Data from multiple European centers performing intracoronary ultrasound (ICUS) examinations were collected under the auspices of the Subgroup on Intravascular Ultrasound of the Working Group on Echocardiography of the European Society of Cardiology. Information was obtained about the number of examinations performed, complications related to ICUS imaging, and any adverse clinical consequences related to ICUS imaging. Twelve centers submitted information about their experience with ICUS. Eight (1.1%) complications were reported (spasm, vessel dissection, or guide wire entrapment) in a total of 718 examinations. All complications occurred in patients with atherosclerotic coronary disease with a diagnosis of unstable or stable angina who underwent percutaneous transluminal coronary angioplasty. No permanent adverse clinical consequences due to ICUS imaging were reported. There was no difference in frequency of complications between centers, as assessed by chi-square analysis (P = 0.232). These data suggest that ICUS examinations can be performed safely with a very low rate of complications.

Guide-wire entrapment by inferior vena caval filters: in vitro evaluation.

To study guide-wire engagement and entrapment by inferior vena caval (IVC) filters. Patterns of engagement were determined in six IVC filters with four commonly used guide wires in a simulated IVC. Force required to disengage guide wires from filters was measured. Eleven engagement patterns were identified with J-tipped guide wires; straight guide wires never engaged. The Simon-Nitinol filter engaged guide wires with the highest frequency (P < .05). The 15-J wire was engaged most frequently overall (P < .0005) but disengaged with forces not significantly different (P > .05) from those required to open the J. Entrapment occurred with only the Vena-Tech (VT) and 12-F stainless steel Greenfield (12SSG) filters and the 1.5-J and 3-J guide wires. The former guide wire became entrapped regardless of engagement pattern; the latter became entrapped only when engaged in the hole in the apex of the 12SSG and VT filters. Guide wires with a J tip 3 mm or less in radius are at risk for entrapment by the 12SSG and VT filters.

734-3 The Safety of Intracoronary Ultrasound: Data from a Multicenter European Registry

The clinical use of intracoronary ultrasound (ICUS) is growing, serving as a useful adjuvant to contrast angiography, and providing additional information to assist with catheter based interventions. Despite the increasing use of this technique, it remains an invasive procedure which the safety has not been definitively established. Data was collected from multiple European centers performing intracoronary ultrasound examinations under the auspices of the Subgroup on Intravascular Ultrasound of the Working Group on Echocardiography of the European Society of Cardiology. Information was obtained about the number of exams performed, complications related to imaging, patient's age and CAD risk factors, indication for exam, concomitant procedures performed, catheter size and location, and any adverse clinical consequences related to ICUS imaging. Twelve centers (mean 59 patients, range 3–140) submitted information about their experience with ICUS. A total of eight (1.1%) complications were reported in a total of 718 examinations. All complications occurred during ICUS exams in patients with atherosclerotic coronary disease with a diagnosis of unstable or stable angina who underwent PTCA. Four cases of transient vessel spasm were seen, all of which resolved after administration of nitroglycerin. Two cases of vessel dissection were noted when imaging after PTCA, and thought to be “possibly” related to the ultrasound catheter. Two cases of guidewire entrapment after distal advancement of the transducer were reported, requiring the catheter and guidewire to be withdrawn. No adverse clinical consequences due to ICUS imaging were reported. There was no difference in frequency of complications between centers assessed by Chi square (p = 0.232). Intracoronary ultrasound examinations can be performed safely with a very low rate of acute complications.

Accordion right coronary artery: An unusual complication of ptca guidewire entrapment

The contour of the epicardial coronary vessels may change considerably during coronary angioplasty. We report the extreme and unique "accordion-like" wrinkling of the mid right coronary artery as a result of distal guidewire entrapment during coronary angioplasty. Recognition of this artifact and its treatment may prevent further complications of coronary angioplasty.

Entrapment of broken guidewire in the left main coronary artery during percutaneous transluminal coronary angioplasty

The distal end of a flexible, steerable guidewire broke during an attempted percutaneous transluminal coronary angioplasty of the left anterior descending coronary artery and was retained in the left main coronary artery. It was successfully removed surgically. Etiology of, management of, and precautions for avoiding this complication are discussed.