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Left main approach for retrieval of retained guidewire fragment
Hussein S Al-Amri1, Abdulrahman M AL-Moghairi, Antonio M Calafiore
1Department of Adult Cardiology, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia.
Insights
Guidewire fractures during percutaneous coronary intervention are rare but serious. Surgical extraction via a left main approach was necessary for a patient with a retained guidewire fragment causing acute coronary thrombosis.
Area of Science:
- Interventional Cardiology
- Cardiovascular Surgery
Background:
- Guidewire fractures during percutaneous coronary intervention (PCI) are infrequent but associated with severe complications.
- These complications include embolization, thrombus formation, and vessel perforation.
- Percutaneous retrieval is the preferred method for fragment removal; however, surgical extraction is necessary when percutaneous methods fail.
Abstract:
Entrapment and detachment of guidewire fractures during percutaneous coronary intervention (PCI) are very rare, but can lead to life-threatening complications such as embolization, thrombus formation, and perforation. Surgical extraction of the remnant fragments is recommended if the percutaneous retrieval is not possible. We present a case of remnant guidewire into the left anterior descending artery (LAD) and aorta that led to acute coronary thrombosis following primary angioplasty. Surgical retrieval was possible only through a left main (LM) approach.
