Successful Bailout of Guidewire Entrapment Within a Coronary Stent Using a Tornus Penetration Catheter: A Case Report

Guidewire entrapment within an implanted coronary stent is a rare but potentially serious complication of percutaneous coronary intervention (PCI), and its management can be technically challenging. An 81-year-old woman presenting with acute myocardial infarction underwent PCI for a severely stenotic lesion in the right coronary artery. After drug-eluting stent implantation and post-dilatation, intravascular ultrasound (IVUS) revealed deformation at the distal edge of the stent. During withdrawal of the IVUS catheter, the catheter and guidewire became entangled with the deformed stent. Although the IVUS catheter was successfully removed with careful manipulation, the guidewire remained firmly entrapped within the stent and could not be retrieved despite repeated attempts. A Tornus penetration catheter was subsequently advanced over the entrapped guidewire using rotational manipulation toward the site of entrapment. When the catheter reached the entrapped segment, the guidewire was successfully disengaged from the stent and retrieved. Following successful bailout, distal stent fracture and proximal coronary dissection were identified, requiring additional stent implantation. This case demonstrates a potential bailout technique for guidewire entrapment within a coronary stent. Rotational advancement of a penetration catheter to the site of entrapment may facilitate disengagement of an entrapped guidewire when standard manipulation is unsuccessful.