Surgical removal of guidewire entrapped within stent struts during percutaneous coronary angioplasty
Onk Alper Oruc1, Mehmet Aksüt, Eftal Murat Bakirci
1Department of Cardiovascular Surgery, Erzincan University Medical Faculty, Mengucek Gazi Education and Research Hospital, Erzincan. oralponk99@yahoo.com.
Insights
Guidewire entrapment during complex coronary angioplasty is a rare but serious complication. Surgical removal and bypass grafting were necessary in a recent case, highlighting potential risks of percutaneous coronary interventions.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Surgery
Background:
- Percutaneous coronary angioplasty is increasingly used for complex coronary artery lesions.
- Device complications like stent or guidewire entrapment can occur, though rarely.
- These complications may lead to severe outcomes if not managed promptly.
Observation:
- A patient undergoing primary percutaneous coronary angioplasty for a complex lesion experienced guidewire entrapment.
- The guidewire became trapped within the struts of the intracoronary stent.
- This rare complication occurred during the primary intervention procedure.
Findings:
- The entrapped guidewire could not be retrieved percutaneously.
- Surgical exploration was required for device removal.
- Coronary artery bypass grafting (CABG) was subsequently performed.
Implications:
- This case underscores the potential for rare but severe complications during complex percutaneous coronary interventions.
- It highlights the importance of considering surgical intervention when percutaneous retrieval of entrapped devices fails.
- Management strategies for device entrapment in coronary arteries may need to be refined.
Abstract:
There has been a growing trend toward percutaneous coronary angioplasty for complex coronary artery lesions. Stent or guidewire break off or trapping within the coronary artery lumen is a rare complication, but it may have fatal consequences. In such cases, the entrapped device may be removed by either percutaneous route or surgical exploration. Here, we report a patient with guidewire entrapment within the struts of the intracoronary stent during primary percutaneous coronary angioplasty, which necessitated surgical removal and subsequent coronary artery bypass grafting (CABG).
