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Broken guidewire - A tale of three cases
1Associate Professor, Dept. of Cardiology, Burdwan Medical College, P 3 Lake Gardens Govt. Housing, 48/4 Sultan Alam Road, Calcutta 33, India.
Insights
Guidewire fracture during percutaneous coronary intervention is rare but serious. Management options for retained fragments vary, including conservative approaches, retrieval, stenting, or surgery.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
Background:
- Guidewire fracture is a rare complication during percutaneous coronary intervention (PCI).
- Retained guidewire fragments pose risks like thrombosis, embolism, dissection, perforation, and vessel occlusion.
Observation:
- This report details three distinct cases of fractured guidewires.
- Each case presented a unique management strategy.
Findings:
- Management approaches included conservative observation, percutaneous retrieval of fragments, using a second stent to secure the fragment, and open-heart surgery.
- The optimal strategy for managing fractured guidewires remains a subject of debate.
Implications:
- Diverse management options exist for guidewire fractures during PCI.
- Case-by-case decision-making is crucial for optimal patient outcomes in this rare complication.
Abstract:
Guidewire fracture is a rare complication of percutaneous coronary intervention. Retained guide wire fragments in the coronary tree can cause thrombosis, embolic phenomena, dissection, perforation, and vessel occlusion. The management of this complication is still debated and it involves conservative management of leaving wire alone, percutaneous retrieval of fractured fragment, use of second stent to crush the wire, or open heart surgery. Here, I am reporting three cases of broken guidewire and they have been managed in three different ways.
