Surgical management for a retained guidewire in vivo during percutaneous coronary interventions following acute myocardial infarction from descending thoracic aorta to external iliac artery: a case report

M. Fidah Hossain; M. Shamim Reza; Swadesh R. Sarker; Sultan Mahmud; Masrur A. Khan; Muhammad M. Hoque; M. Shadequl Islam; Mezbahur Rahman; Anami Mallick; Anup K. Saha

doi:10.18203/issn.2454-2156.IntJSciRep20240446

Authors

M. Fidah Hossain Department of Vascular Surgery, National Institute of Cardiovascular Disease and Hospital, Shere-Bangla Nagar, Dhaka, Bangladesh
M. Shamim Reza Department of Vascular Surgery, National Institute of Cardiovascular Disease and Hospital, Shere-Bangla Nagar, Dhaka, Bangladesh
Swadesh R. Sarker Department of Vascular Surgery, National Institute of Cardiovascular Disease and Hospital, Shere-Bangla Nagar, Dhaka, Bangladesh
Sultan Mahmud Department of Vascular Surgery, National Institute of Cardiovascular Disease and Hospital, Shere-Bangla Nagar, Dhaka, Bangladesh
Masrur A. Khan Department of Vascular Surgery, National Institute of Cardiovascular Disease and Hospital, Shere-Bangla Nagar, Dhaka, Bangladesh
Muhammad M. Hoque Department of Vascular Surgery, National Institute of Cardiovascular Disease and Hospital, Shere-Bangla Nagar, Dhaka, Bangladesh
M. Shadequl Islam Department of Vascular Surgery, National Institute of Cardiovascular Disease and Hospital, Shere-Bangla Nagar, Dhaka, Bangladesh
Mezbahur Rahman Department of Vascular Surgery, National Institute of Cardiovascular Disease and Hospital, Shere-Bangla Nagar, Dhaka, Bangladesh
Anami Mallick Department of Vascular Surgery, National Institute of Cardiovascular Disease and Hospital, Shere-Bangla Nagar, Dhaka, Bangladesh
Anup K. Saha Department of Vascular Surgery, National Institute of Cardiovascular Disease and Hospital, Shere-Bangla Nagar, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/issn.2454-2156.IntJSciRep20240446

Keywords:

Guidewire entrapment, Guidewire in vivo, Retention of guidewire following coronary angiogram

Abstract

This case report describes the unique presentation of a 60-year-old woman who was referred from the cardiology department due to the retention of a guidewire following a coronary angiogram. The guidewire was inadvertently left in the right external iliac artery after the angiogram procedure. This report discusses the clinical presentation, diagnostic procedures, and successful management of this case without unusual complication. The successful removal of the retained guidewire culminated in a favourable outcome for the patient. Efforts to extract residual guide-wire fragments from the coronary circulation are generally the preferred course of action. Nevertheless, certain case reports and series have proposed that, in carefully selected patients, leaving the guide-wires in situ without attempting extraction may be a reasonable option when the likelihood of successful removal appears remote, considering anatomical and technical factors. For such cases, a more suitable approach involves administering systemic anticoagulation and antiplatelet agents, coupled with vigilant follow-up.

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References

Hartzler GO, Rutherford BD, McConahay DR. Retained percutaneous transluminal coronary angioplasty equipment components and their management. Am J Cardiol. 1987;60(16):1260-4.

Eggebrecht H, Haude M, Von Birgelen C, Oldenburg O, Baumgart D, Welge D, et al. Nonsurgical Retrieval of Embolized Coronary Stents. Catheterization and Cardiovascular Interventions. 2000;51:432-40.

Tamci B, Okan T, Gungor H, Ozturk V, Cam F. Stent entrapment and guide wire fracture during percutaneous coronary intervention in the same patient. Adv Interv Cardiol. 2013;9(2):190-3.

Steffenino G, Meier B, Finci L, Velebit V, von Segesser L, Faidutti B, et al. Acute complications of elective coronary angioplasty: a review of 500 consecutive procedures. Br Heart J. 1988;59(2):151-8.

Lotan C, Hasin Y, Stone D, Meyers S, Applebaum A, Gotsman MS. Guide wire entrapment during PTCA: a potentially dangerous complication. Catheterization and cardiovascular diagnosis. 1987;13(5):309-12.

Vrolix M, Vanhaecke J, Piessens J, De Geest H. An unusual case of guide wire fracture during percutaneous transluminal coronary angioplasty. Catheterizat Cardiovasc Diagnosis. 1988;15(2):99-102.

Khonsari S, Livermore J, Mahrer P, Magnusson P. Fracture and dislodgment of floppy guidewire during percutaneous transluminal coronary angioplasty. Am J Cardiol. 1986;58(9):855-6.

Iturbe JM, Abdul-Rahman R, Papayannis A, Mahmood A, Rangan BV, Banerjee S, et al. Frequency, treatment, and consequences of device loss and entrapment in contemporary percutaneous coronary interventions. J Invasive Cardiol. 2012;24(5).

Al-Moghairi A, S Al-Amri H. Management of retained intervention guide-wire: a literature review. Curr Cardiol Rev. 2013;9(3):260-6.

Hsieh CA, Ko YL. Side-branch wire entrapment: Early recognition and management. Tzu Chi Med J. 2016;28(3):124-7.

Ghosh PK, Alber G, Schistek R, Unger F. Rupture of guide wire during percutaneous transluminal coronary angioplasty. Mechanics and management. J Thoracic Cardiovasc Surg. 1989;97(3):467-9.