TY - JOUR
T1 - Consequences and treatment of guidewire entrapment and fracture during percutaneous coronary intervention
AU - Danek, Barbara A.
AU - Karatasakis, Aris
AU - Brilakis, Emmanouil S.
N1 - Publisher Copyright:
© 2016.
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Guidewire fracture is an uncommon, yet feared complication of percutaneous coronary intervention that may be more likely to occur in complex lesions and when guidewires interact with newly deployed or pre-existing stents. Wire fragments can often be retrieved using percutaneous techniques, but may need to be removed surgically in case of percutaneous retrieval failure. We present two cases of guidewire entrapment and fracture. In the first case the fractured polymer-jacketed guidewire was successfully retrieved, after crossing the lesion with another guidewire and performing balloon dilation next to the entrapped guidewire. In the second case, attempts for percutaneous guidewire retrieval failed. The wire fragment protruded into the ascending aorta leading to emergent cardiac surgery. We also reviewed the published literature on guidewire fracture and entrapment since 2007, providing an update on risk factors, consequences, and managements of this complication.
AB - Guidewire fracture is an uncommon, yet feared complication of percutaneous coronary intervention that may be more likely to occur in complex lesions and when guidewires interact with newly deployed or pre-existing stents. Wire fragments can often be retrieved using percutaneous techniques, but may need to be removed surgically in case of percutaneous retrieval failure. We present two cases of guidewire entrapment and fracture. In the first case the fractured polymer-jacketed guidewire was successfully retrieved, after crossing the lesion with another guidewire and performing balloon dilation next to the entrapped guidewire. In the second case, attempts for percutaneous guidewire retrieval failed. The wire fragment protruded into the ascending aorta leading to emergent cardiac surgery. We also reviewed the published literature on guidewire fracture and entrapment since 2007, providing an update on risk factors, consequences, and managements of this complication.
KW - Chronic total occlusion
KW - Complications
KW - Guidewires
KW - Percutaneous coronary intervention
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U2 - 10.1016/j.carrev.2015.12.005
DO - 10.1016/j.carrev.2015.12.005
M3 - Review article
C2 - 26826011
AN - SCOPUS:84960797392
SN - 1553-8389
VL - 17
SP - 129
EP - 133
JO - Cardiovascular Revascularization Medicine
JF - Cardiovascular Revascularization Medicine
IS - 2
ER -