Management of Guidewire Entrapment With Laser Atherectomy

J Invasive Cardiol. 2017 May;29(5):E61-E62.

Abstract

A 62-year-old man was referred for percutaneous coronary intervention of a severe circumflex lesion. The guidewire became entangled in the previously implanted left anterior descending artery stent. The left main was engaged with a second guide catheter, followed by balloon dilations, various microcatheters, and laser atherectomy. The wire eventually fractured without protruding into the aorta. The circumflex lesion was stented with two stents, followed by left main stenting that covered the fragment. Caution should be used when wiring through stents; wire fracture can be treated with stent implantation, as long as the wire fragment does not protrude into the aorta.

Publication types

  • Case Reports

MeSH terms

  • Angioplasty, Balloon, Coronary / adverse effects*
  • Angioplasty, Balloon, Coronary / instrumentation*
  • Atherectomy / methods
  • Cardiac Catheters / adverse effects*
  • Coronary Angiography / methods
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / therapy*
  • Device Removal
  • Equipment Failure
  • Follow-Up Studies
  • Humans
  • Laser Therapy / methods*
  • Male
  • Middle Aged
  • Risk Assessment
  • Stents
  • Treatment Outcome