Related Experiment Video
Updated: Jan 4, 2026
Magnetically-Assisted Remote Controlled Microcatheter Tip Deflection under Magnetic Resonance Imaging
Published on: April 4, 2013
Successful percutaneous retrieval of a detached microcatheter tip using the guide-extension catheter trapping
Takuya Tsujimura1, Takayuki Ishihara1, Osamu Iida1
1Cardiovascular Center, Kansai Rosai Hospital, Amagasaki, Japan.
Insights
A novel technique successfully retrieved a detached microcatheter tip during percutaneous coronary intervention for severe left circumflex artery stenosis. This guide-extension catheter trapping method offers a safe solution for managing dislodged devices in complex coronary interventions.
Area of Science:
- Interventional Cardiology
- Medical Device Technology
Background:
- Percutaneous coronary intervention (PCI) is a common procedure for treating coronary artery disease.
- Complications such as device detachment can occur during complex PCI, necessitating innovative retrieval techniques.
Observation:
- During PCI for severe left circumflex artery stenosis, a microcatheter tip detached at the lesion site.
- The detached radiopaque tip posed a risk of further complications within the coronary artery.
Findings:
- A guide-extension catheter was advanced to the detached tip.
- The tip was then trapped using a small balloon catheter within the guide-extension catheter.
- This "trapping technique" enabled the successful percutaneous retrieval of the detached microcatheter tip.
Implications:
- The guide-extension catheter trapping technique provides a valuable method for managing detached or entrapped devices during PCI.
- This approach can enhance procedural safety and improve outcomes in complex coronary interventions.
- Adverse events related to device failure can be effectively managed with specialized techniques.
Abstract:
A 55-year-old male with stable angina pectoris was referred to our hospital. Coronary angiography showed severe stenosis from the proximal to the middle part of the left circumflex artery (LCX). Based on the severity of lesion calcification, we performed percutaneous coronary intervention with rotational atherectomy. After crossing a 0.014-inch guidewire, we replaced it with a rotawire using a microcatheter. Following the retrieval of the microcatheter, we noted that a radiopaque tip of the microcatheter had been detached at the site of severe stenosis in the proximal part of the LCX. We advanced a guide-extension catheter to this site and wedged the detached tip using a balloon catheter (2.0-mm diameter; 12-mm length) in the guide-extension catheter. The detached tip was successfully retrieved along with the guide-extension catheter. After passing two guidewires into the main vessel and the side branch, we dilated the lesion using a 2.5-mm non-compliant balloon. Finally, we implanted two sirolimus-eluting stents, followed by post-dilatation with a 3.75-mm non-compliant balloon. This approach resulted in excellent dilatation and blood flow. Use of the guide-extension catheter trapping technique (i.e. use of a guide-extension catheter and a small balloon catheter) resulted in the successful percutaneous retrieval of a detached microcatheter tip. <Learning objective: We occasionally encounter adverse events related to the detachment or breakage of devices when performing percutaneous coronary intervention. The guide-extension catheter trapping technique using a guide-extension catheter and a small balloon is a useful approach for the retrieval of dislodged or entrapped devices.>.
