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Guide wire entrapment during PTCA: a potentially dangerous complication
Catheterization and Cardiovascular Diagnosis
|September 1, 1987
Insights
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.
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.
- 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.
Abstract:
The tip of a "high-torque" floppy guide wire became entrapped in a coronary artery during elective PTCA in four patients. In two it was removed through the guiding catheter, in the third an operative intervention was needed in order to free the wire, and in the fourth the remnant was left in situ. Interventional cardiologists should be aware of this potential complication.