Surgical retrieval of fractured guidewire during percutaneous coronary intervention: A case report

Medical Reports Pub Date : 2025-04-23 DOI:10.1016/j.hmedic.2025.100219

Wajiha Arshad , Alifa Sabir , Sahab Ahmad , Muhammad Azam , Abdur Rehman , Arham Ihtesham , Shahzaib Maqbool , Saba Shafiq

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Abstract

Percutaneous coronary intervention (PCI) is a common treatment for coronary artery disease, but rare complications, such as guidewire fracture, can occur. This report describes a 63-year-old Southeast Asian male with inferior wall myocardial infarction (IWMI) who underwent primary PCI at a secondary care center. While revascularizing the right coronary artery (RCA), the guidewire fractured during left circumflex artery (LCX) stenting. Transferred to a tertiary unit in an unstable condition, redo-angiography revealed the fractured guidewire lodged in the distal left main stem (LMS). After unsuccessful percutaneous retrieval attempts, the patient underwent coronary artery bypass grafting (CABG). The guidewire was successfully retrieved from the LMS and aorta. Although rare, guidewire fractures during PCI can cause severe complications like vessel perforation, thrombus, and embolization. Early detection and management, including surgical intervention when required, are vital to prevent life-threatening outcomes.

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经皮冠状动脉介入治疗中导丝断裂的手术复位一例

经皮冠状动脉介入治疗（PCI）是冠状动脉疾病的常用治疗方法，但罕见的并发症，如导丝断裂，可发生。本报告描述一位63岁东南亚男性下壁心肌梗死（IWMI）患者在二级护理中心接受初级PCI治疗。在对右冠状动脉（RCA）进行血运重建时，导丝在左旋动脉（LCX）支架置入过程中断裂。在不稳定的情况下转移到第三单元，血管造影显示骨折的导丝卡在左主干远端（LMS）。经皮取血失败后，患者接受冠状动脉旁路移植术（CABG）。导丝成功地从LMS和主动脉中取出。虽然罕见，但在PCI术中导丝骨折会引起严重的并发症，如血管穿孔、血栓和栓塞。早期发现和处理，包括必要时的手术干预，对于防止危及生命的后果至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Medical Reports

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