Rupture of guide wire during percutaneous transluminal coronary angioplasty, a case report

Kılıç, Harun; Akdemir, Ramazan; Biçer, Asuman

doi:10.1016/j.ijcard.2007.05.088

Cited by 10 publications

(7 citation statements)

References 7 publications

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“…17,18,29 The endovascular management remains another important treatment option with a number of different interventional techniques described: snare loop, double or triple wire technique, deep-guide catheter wedge, and balloon inflation techniques or stenting against the vessel wall. 5,6,12,30,31 Currently, there is no sufficient data of the use of extracorporeal mechanical circulatory support during endovascular management, but its use in cases of hemodynamic instability appears plausible in patients with contraindications for surgery.…”

Section: Discussionmentioning

confidence: 99%

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et al. 2020

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Background Device complications in complex percutaneous coronary interventions are rare but potentially deadly. Surgical removal is often required. However, an evaluation of surgical therapy beyond case reports is practically not existent. Methods We prospectively followed all cases of retained guide wires and/or other devices referred to us for surgical removal between 2015 and 2019 and retrospectively searched our database for such cases between 2010 and 2014. Results From 2015 on, eight cases were referred for surgical removal from six different cardiology departments. In the 5 years before, there was not a single case. Six patients were operated emergently. Patients were 60.5 ± 5.42 years old, overweight (body mass index 30.1 ± 3.77) and except for one case (left ventricular‐assist device) showed preserved ejection fraction (EF) (mean EF 57 ± 18.01). The retained devices were mostly located in the right coronary artery (50%), followed by the circumflex artery (37.5%) and diagonal branch (12.5%). The devices were remnants of guide wires (n = 4), balloon catheters (n = 3), and in one case a rotablator. Full sternotomy was performed in six patients and two received a left‐sided minithoracotomy (n = 2). The operations were performed on‐pump in five (62.5%) and off‐pump in three patients. Complete extraction of the foreign bodies was possible in all patients. Two patients died; one in unrelated multiorgan failure and one due to retained‐device‐related right heart failure. The other patients survived and had uneventful postoperative courses. Conclusions Retained foreign bodies from cardiac interventions can be completely removed surgically using individualized approaches. There appears to be a trend toward a rising incidence of such interventional complications.

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Section: Discussionmentioning

confidence: 99%

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et al. 2020

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“…However, if retrieval of a guide wire is impossible, controversy remains about the preferred treatment and the decision is mostly influenced by the clinical situation and the position of the wire [2,3,4,5]. Despite the risk of thrombosis with vessel occlusion or embolization, there is also a clear and unpredictable risk of migration.…”

Section: Discussionmentioning

confidence: 99%

Extravascular Migration of a Guide Wire with Perforation of the Heart Eight Months after Percutaneous Coronary Intervention: Consequence of a Conservative Approach

et al. 2012

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Impingement of a guide wire is not unusual during complex percutaneous coronary intervention procedures. It is mostly retrieved by endovascular procedures. If not possible, conservative therapy is frequently the next option, leaving the guide wire in place. This case describes the consequence of such an approach 9 months after initial percutaneous coronary intervention. The guide wire migrated through the abdominal cavity and finally perforated the heart. We therefore defend a more aggressive approach if a guide wire is locked in or lost. Surgical retrieval seems to be the best choice. Fixation of the guide wire with a stent is an acceptable alternative in high-risk patients.

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“…There are several methods recommended for the management of fractured guide wires, including emergent surgery, loop snare removal, two- or three-wire rotation, stenting over the retained wire, and conservative treatment 6-8). Surgical extraction is strongly recommended in cases of protrusion of the guide wire into the ascending aorta 9-11). However, guide wire segments retained within the coronary circulation may remain benign for a long time, particularly if they are entrapped within a distal part of the vessel and do not have accompanying total coronary occlusions 3).…”

Section: Discussionmentioning

confidence: 99%

A Case of Guide Wire Fracture With Remnant Filaments in the Left Anterior Descending Coronary Artery and Aorta

Hong

Lee

2010

Korean Circ J

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Guide wire fractures during percutaneous coronary intervention (PCI) are very rare, but when they do occur they may lead to life-threatening complications, such as embolization, thrombus formation and perforation. In cases when percutaneous retrieval has failed, surgical extraction of the remnant fragments is recommended. We present a case of remnant guide wire filaments that remained in place without complications, over a one-year clinical follow up period.

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Rupture of guide wire during percutaneous transluminal coronary angioplasty, a case report

Cited by 10 publications

References 7 publications

Lost in circulation

Lost in circulation

Extravascular Migration of a Guide Wire with Perforation of the Heart Eight Months after Percutaneous Coronary Intervention: Consequence of a Conservative Approach

A Case of Guide Wire Fracture With Remnant Filaments in the Left Anterior Descending Coronary Artery and Aorta

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