Broken guidewire during primary percutaneous coronary intervention.

Abstract

A 68-year-old female patient was admitted to emergency room with acute anterior myocardial infarction. Her coronary angiography revealed an acute total occlusion in the ostial segment of the left anterior descending coronary artery (LAD) (Fig. 1). The lesion was successfully crossed with a floppy guidewire (Fig. 2) and then predilated with balloon. Because of the close proximity of the lesion to the left main coronary artery (LMCA), a second guidewire was tried to send to the left circumflex artery (CX). The tip of the guidewire became curved while trying to pass the CX. Then it was thought to change the guidewire with another one. The tip of the second guidewire was broken inside the guiding catheter while pulling back but it was not understood during the procedure. Then another guidewire was passed to CX. A bare metal stent was sent to the lesion in LAD. When the stent arrived to the lesion area, the broken tip of the guidewire was seen at the end of the stent as a ring and entrapped over the culprit lesion (Fig. 3). The stent was crossed within