Intravascular retrieval of broken guide wire from the ascending aorta after percutaneous transluminal coronary...

Area of Science:

• Interventional Cardiology
• Cardiovascular Surgery
• Medical Device Technology

Background:

• Percutaneous coronary angioplasty (PCA) is a common procedure for treating coronary artery stenosis.
• Guide wire fractures are a rare but serious complication during interventional cardiology procedures.
• Ensuring guide wire integrity is crucial for procedural success and patient safety.

Observation:

• During a PCA of a proximal right coronary artery stenosis, the guide wire fractured.
• The distal segment of the fractured guide wire lodged in the right coronary artery.
• The proximal segment of the fractured guide wire migrated to the ascending aorta.

Findings:

• A Dotter retrieval catheter was employed to address the guide wire remnant.
• The retrieval catheter successfully snared the intra-aortic portion of the fractured guide wire.
• The fractured guide wire segment was safely removed from the ascending aorta.

Implications:

• This case demonstrates a successful retrieval of a fractured guide wire from the aorta, preventing further complications.
• The use of a Dotter retrieval catheter offers a viable solution for managing guide wire embolization during PCA.
• Awareness of this complication and retrieval techniques is important for interventional cardiologists.