Septal wire entrapment during recanalisation of a chronic total occlusion with the retrograde approach

We report the case of an unsuccessful attempt at recanalisation of a chronic total occlusion via the retrograde approach, and describe a rare complication, guide wire entrapment in the donor artery and septal branch. Several conventional attempts to retrieve the guide wire were unsuccessful and led to wire fracture. A new approach, involving very deep guiding catheter intubation followed by a double guide wire rotary motion, was then used to retrieve the proximal end of the wire fragment and re-engage the uncoiled segment within the distal part of the donor artery. After assessment of the length of the remaining distal end of the wire segment with intravascular ultrasound, stent implantation crushed the wire filament to the vessel wall.