Retained Guidewire Following Perforator Vein Ablation

Wire embolization is a rare but potentially serious complication of endovascular procedures. Endovenous thermal ablation is a minimally invasive procedure widely used to treat chronic venous insufficiency. Herein, we report a case of guidewire embolization into the posterior tibial and popliteal veins during endovenous laser ablation treatment that was successfully managed with open surgical retrieval. Because of the extensive length and location of the retained guidewire, inability to obtain reliable distal venous access, and concern for further migration or venous injury with percutaneous manipulation, open surgical retrieval was selected. The guidewire was successfully removed through popliteal vein exploration without perioperative complications. This case highlights the importance of recognizing retained intravascular foreign bodies promptly and maintaining open surgical retrieval as an option when endovascular techniques increase procedural risk.