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Related Experiment Videos

Guide wire entrapment during PTCA: a potentially dangerous complication.

C Lotan1, Y Hasin, D Stone

  • 1Cardiology Department, Hadassah University Hospital, Jerusalem, Israel.

Catheterization and Cardiovascular Diagnosis
|September 1, 1987
PubMed
Summary

A high-torque floppy guide wire tip can become entrapped in a coronary artery during percutaneous transluminal coronary angioplasty (PTCA). Awareness of this complication is crucial for interventional cardiologists to ensure patient safety.

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Area of Science:

  • Interventional Cardiology
  • Cardiovascular Medicine
  • Medical Device Technology

Background:

  • Percutaneous transluminal coronary angioplasty (PTCA) is a common procedure for treating coronary artery disease.
  • Guide wires are essential tools used during PTCA to navigate and deliver devices to the target lesion.
  • High-torque floppy guide wires offer enhanced maneuverability but may pose specific risks.

Observation:

  • A "high-torque" floppy guide wire tip became entrapped within a coronary artery in four patients undergoing elective PTCA.
  • The entrapment occurred during the guide wire manipulation phase of the procedure.
  • This complication highlights a potential failure mode of specific guide wire designs.

Findings:

  • In two cases, the entrapped guide wire tip was successfully retrieved using the guiding catheter.

Related Experiment Videos

  • One patient required surgical intervention to free the entrapped guide wire.
  • In a fourth case, the remaining portion of the guide wire was intentionally left in place.

    • Implications:

    • Interventional cardiologists must be vigilant for guide wire entrapment during PTCA procedures.
    • This complication necessitates careful guide wire selection and manipulation techniques.
    • Developing strategies to mitigate or manage guide wire entrapment is important for patient safety and procedural success.