Surgical Retrieval of Protective Guidewire That Spontaneously Fractured in the RCA and Penetrated the Vessel

Guidewire fracture is a rare and serious complication of percutaneous coronary intervention, especially when it is "standing by" as a protective one.

We present a case in which a protective guidewire in the right coronary artery spontaneously fractured during percutaneous coronary intervention for chronic total occlusion lesion of the left anterior descending artery. The fractured guidewire pierced the vessel and entered the pericardium before any measures could be taken, and a percutaneous retrieval attempt using the twisting wire technique failed. The patient developed cardiac tamponade, and emergency surgery was performed to remove the fractured guidewire.

Greater prudence is required when choosing guidewires during percutaneous coronary intervention. Coiled guidewires may not be suitable for use as a protective guidewire.