Side-branch wire entrapment: Early recognition and management

Hsieh, Chien-An; Ko, Yu‐Lin

doi:10.1016/j.tcmj.2014.12.003

Cited by 3 publications

(3 citation statements)

References 13 publications

(16 reference statements)

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“…Strategies to prevent guidewire entrapment include maintaining proper wire positioning, avoiding excess angulation in the wire, and maintaining backward traction during stent advancement. 10 The attempt to remove the entrapped guidewire by twisting with mild back-tension in this patient could increased the chance of fracture of wire, aortic wall dissection, retained wire fragment, further dislodgement. Retained guidewire fragments in the coronary tree can lead to lifethreatening complications such as perforation, dissection, vessel occlusion, thrombosis, and embolism.…”

Section: Discussionmentioning

confidence: 86%

Surgical management for a retained guidewire in vivo during percutaneous coronary interventions following acute myocardial infarction from descending thoracic aorta to external iliac artery: a case report

Hossain,

Reza,

Sarker

et al. 2024

Int J Sci Rep

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This case report describes the unique presentation of a 60-year-old woman who was referred from the cardiology department due to the retention of a guidewire following a coronary angiogram. The guidewire was inadvertently left in the right external iliac artery after the angiogram procedure. This report discusses the clinical presentation, diagnostic procedures, and successful management of this case without unusual complication. The successful removal of the retained guidewire culminated in a favourable outcome for the patient. Efforts to extract residual guide-wire fragments from the coronary circulation are generally the preferred course of action. Nevertheless, certain case reports and series have proposed that, in carefully selected patients, leaving the guide-wires in situ without attempting extraction may be a reasonable option when the likelihood of successful removal appears remote, considering anatomical and technical factors. For such cases, a more suitable approach involves administering systemic anticoagulation and antiplatelet agents, coupled with vigilant follow-up.

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Section: Discussionmentioning

confidence: 86%

Surgical management for a retained guidewire in vivo during percutaneous coronary interventions following acute myocardial infarction from descending thoracic aorta to external iliac artery: a case report

Hossain,

Reza,

Sarker

et al. 2024

Int J Sci Rep

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“…We also stress that this method may need additional caution when an SB lesion has severe calcification, or when a two‐stent strategy is necessary because of risks of wire entrapment and fracture in such situations even with conventional wire . Interventionists should also have the knowledge to remedy an entrapped wire, either with ballooning with a low‐profile balloon over the jailed‐pressure wire or using a surgical procedure to manage this …”

Section: Discussionmentioning

confidence: 99%

“…30 Interventionists should also have the knowledge to remedy an entrapped wire, either with ballooning with a low-profile balloon over the jailed-pressure wire or using a surgical procedure to manage this. 33…”

Section: Clinical Implicationmentioning

confidence: 99%

Feasibility and safety of jailed‐pressure wire technique using durable optical fiber pressure wire for intervention of coronary bifurcation lesions

Omori

Kawase

Hara

et al. 2019

Cathet Cardio Intervent

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Objectives The objective was to evaluate the safety, feasibility, and accuracy of the jailed‐pressure wire technique using a durable optical fiber‐based pressure wire with high‐pressure dilatation using a non‐compliant balloon after main vessel stenting. Background Fractional flow reserve (FFR) information can help interventionists determine whether they should treat a jailed‐side branch (SB). However, re‐crossing a pressure wire into a jailed‐SB is sometimes technically difficult. Methods Fifty‐one consecutive lesions from 48 patients who underwent the jailed‐pressure wire technique were retrospectively investigated. The primary endpoint was complication rate and secondary endpoints included success rate of FFR measurement, incidence of wire disruption, and final drift rate. The usability of FFR for percutaneous coronary intervention of coronary bifurcation lesion was also evaluated. Results Median age of the patients was 69 years and 80.4% were men. The most frequent underlying disease was stable angina (70.6%) and 68.6% were type B2 lesions. Our main findings were: the procedure was performed successfully in all cases without any complications or wire disruption, FFR could be measured without significant final drift in 95.9% of cases, and FFR measurements helped interventionists determine whether to perform a final kissing balloon dilatation in 49.0% cases. Conclusions The jailed‐pressure wire technique using a durable optical fiber‐based pressure wire with high‐pressure post‐dilatation maneuver was safe, feasible, and accurate.

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Management of Guidewire Entrapment and Fracture During Percutaneous Coronary Intervention: When All Bailout Techniques Fail!

Sharma

Pfeffer

Kwon

et al. 2023

Texas Heart Institute Journal

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A 55-year-old man presented with chest pain and was diagnosed with non–ST-segment elevation myocardial infarction. Coronary angiography revealed a 95% eccentric lesion in the mid-right coronary artery. After 3 intracoronary stents were placed, the guidewire became entrapped in 1 of the stents; multiple attempts at retrieval were unsuccessful. Ultimately, the guidewire fractured, and a coronary artery bypass graft surgery was performed to remove the guidewire fragments. This report reviews the procedural steps for wire retrieval that are critical for operators to avoid coronary artery bypass surgery.

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Side-branch wire entrapment: Early recognition and management

Abstract: Side-branch wire (SBW) entrapment has been reported with increasing frequency recently. We report early recognition of SBW entrapment in a 60-year-old woman.

Cited by 3 publications

References 13 publications

Surgical management for a retained guidewire in vivo during percutaneous coronary interventions following acute myocardial infarction from descending thoracic aorta to external iliac artery: a case report

Surgical management for a retained guidewire in vivo during percutaneous coronary interventions following acute myocardial infarction from descending thoracic aorta to external iliac artery: a case report

Feasibility and safety of jailed‐pressure wire technique using durable optical fiber pressure wire for intervention of coronary bifurcation lesions

Management of Guidewire Entrapment and Fracture During Percutaneous Coronary Intervention: When All Bailout Techniques Fail!

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