Surgical retrieval of entrapped coronary angioplasty guidewire from the aorta

Abstract

An entrapped or retained coronary angioplasty guidewire is a rare but serious complication of coronary interventions. A failed percutaneous transluminal coronary angioplasty attempt on the left anterior descending artery in a 35-year-old man was complicated by entrapment of the guidewire. Under cardiopulmonary bypass and cardioplegic arrest, the whole length of the entrapped guidewire was retrieved successfully from the left anterior descending artery and the aorta through an aortotomy following revascularization with left internal mammary artery.

A case report of entrapped angioplasty balloon in circumflex coronary artery

“…The presence of entrapped devices in a coronary arteries could lead to potentially fatal complications such as acute embolization, acute coronary thrombosis, coronary rupture leading to tamponade and myocardial infarction [7].…”

“…After removal of foreign body from aortotomy site, simple bypass grafting seems to be reasonable due to possible risk of coronary occlusion and the inability to inspect the patency of the vessel [3,7].…”

“…Entrapment, retention or fracture of a coronary angioplasty hardware such as stent, coronary balloon shaft, femoral arterial sheath, and guidewire is a rare but serious complication of coronary interventions. Loss or entrapment of device can result in intracoronary or systemic embolization, thrombus formation, emergent coronary artery bypass graft surgery, or death [1].…”

Successful retrieval of a retained J guidewire from the right atrium and aorta arch using a self-invented snare device

“…[2][3][4] In the few existing recent reports, the retained guidewires were mostly 0.014" or 0.021" micro-guidewires, and the methods of management included the use of a gooseneck micro-snare, stenting against the vessel wall, deep-guided catheter wedging with balloon inflation and cardiovascular surgery. 3,5,6 Here, we provide the first report of a case of accidental retention of a 0.035" J guidewire in the right atrium and aortic arch during basilar artery aneurysm embolization. After considering the difference in hydrophilic properties between the J guidewire and micro-guidewires and the retention characteristics in this case, we successfully retrieved the wire using a self-invented snare device, thus avoiding serious complications.…”

Retained entrapped coronary stent appearing like an aortic flap

“…Entrapment of coronary angioplasty hardware, such as coronary stents, is a rare but serious complication of coronary interventions . Previous studies reported a necessity of surgery in 75% of cases .…”