Retained Coronary Guidewire Extending to the Right Axillary Artery

Area of Science:

• Cardiology
• Interventional Cardiology
• Vascular Surgery

Background:

• ST-segment elevation myocardial infarction (STEMI) requires timely intervention.
• Percutaneous coronary intervention (PCI) is a common treatment for STEMI.
• Complications, though rare, can occur during PCI procedures.

Observation:

• A 56-year-old female experienced a retained guidewire in the left circumflex artery after PCI for inferior STEMI.
• The guidewire extended from the left circumflex artery through the ascending aorta into the right axillary artery.
• Cardiac CT imaging delineated the complex path of the retained guidewire.

Findings:

• Initial percutaneous retrieval was deferred due to stent damage risk.
• The patient was discharged on triple antithrombotic therapy (Aspirin, Clopidogrel, Apixaban) for 3 months.
• No bleeding or thromboembolic complications were observed during follow-up.

Implications:

• Surgical retrieval of the retained guidewire was ultimately performed along with coronary artery bypass grafting (CABG).
• This case underscores the importance of careful guidewire management during PCI.
• Multidisciplinary collaboration between interventional cardiology and vascular surgery is crucial for managing complex procedural complications.