Successful retrieval of a broken intravascular ultrasound catheter tip in the coronary artery

We report the successful retrieval of a broken intracoronary intravascular ultrasound (IVUS) catheter tip that was mostly invisible on fluoroscopy by using a snare catheter and pulling from distal to proximal. An 80-year-old male had presented with effort-related angina for one month. A coronary angiogram revealed severe stenosis of the proximal portion of the left anterior descending artery (LAD). Percutaneous coronary intervention (PCI) was planned for the lesion. During pre-procedural IVUS examination, the IVUS catheter fractured leaving the tip of the IVUS catheter inside the LAD. An attempt was made to remove the IVUS catheter tip by engaging the free proximal end of the tip with a loop snare. This attempt failed due to the free proximal end of the IVUS catheter tip being invisible on fluoroscopy. A loop snare was instead delivered distal to the IVUS catheter tip through a microcatheter, and the IVUS wire of the catheter tip was manipulated into the loop. The loop snare was then pulled back securely catching the IVUS catheter tip. The broken IVUS catheter tip was subsequently removed. This novel technique is effective for retrieving intracoronary foreign bodies.