Coronary embolization of a gauze fragment: a cautionary case report

A 44-year-old woman underwent fractional flow reserve (FFR) assessment of a stenosis of the left circumflex coronary artery. The FFR was within normal limits, however, shortly after leaving the catheterization laboratory the patient developed refractory angina. Repeat angiography demonstrated a new filling defect in the mid left anterior descending coronary artery. Aspiration thrombectomy was performed, and analysis of the effluent revealed a strand of gauze material with adherent thrombus. The gauze fiber was likely unknowingly injected with flush solution during FFR measurement. This previously unreported but potentially dangerous phenomenon underscores the importance of not using a single receptacle to hold moist gauze and saline flush solution, as is the practice in some catheterization laboratories.