Percutaneous retrieval of a fractured coronary catheter: A case report

Abstract

Background

Intravascular angiographic catheter fracture is an extremely rare but critical complication of percutaneous coronary intervention (PCI). Conventional retrieval strategies (e.g., surgical intervention, snares) may prolong procedures and raise peri-procedural complication risks. Herein, we report a case of successful retrieval of a fractured catheter using an innovative technique.

Case presentation

A 59-year-old female with 7-year hypertension was admitted for 3-month recurrent exertional angina. Right radial coronary angiography was performed, during which a TIG catheter fractured ∼8 cm proximal to the ulnar-radial bifurcation in the right brachial artery. Initial attempts to retrieve it via a Runthrough NS guidewire failed.

To retrieve the fragment, we sequentially advanced JR3.5, 6FBL3.0, and 6FJR3.5 guiding catheters via the right radial arterial sheath to the proximal stump, then tried advancing a Cross-IT XTR guidewire along them—this maneuver remained unsuccessful.

Subsequently, an inferior vena cava (IVC) filter retriever via the right radial sheath failed to snare the proximal stump. We then constructed a custom snare by looping a Runthrough NS guidewire at an extension catheter tip, and retrieved the fragment via balloon-assisted counter-traction.

Postoperatively, the patient was stable without complications. Dual antiplatelet therapy and follow-up were initiated, with no adverse events at 1-month follow-up.

Conclusion

This minimally invasive technique obviates surgery, shows promise for intravascular foreign body management, and provides insights for adapting to failed conventional strategies in complex cases.