A retained guidewire fractured with subsequent pericardial tamponade two years after endovascular neurointervention

Interv Neuroradiol. 2019 Feb;25(1):117-120. doi: 10.1177/1591019918801538. Epub 2018 Sep 18.

Abstract

Entrapment of aneurysm embolization hardware is an extremely rare complication of endovascular neurointerventional procedures. We describe a case of a retained guidewire in a 42-year-old male during an aneurysm embolization. After unsuccessful attempts at removal via interventional methods, we decided to leave the guidewire within the vessel. A guidewire fracture resulted in several fragments in the carotid artery and aorta with subsequent cardiac tamponade, pseudoaneurysm and aortojejunal fistula two years later. The fragments in the aorta were removed via interventional and surgical methods. We advocate early surgical management of the retained guidewires after unsuccessful retractions via interventional methods. Meticulous and gentle maneuvering is necessary to prevent such serious complications.

Keywords: Retained wire; complication; interventional neurosurgery; pericardial tamponade; wire fracture.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aneurysm, False / etiology*
  • Aortic Diseases / etiology*
  • Cardiac Tamponade / etiology*
  • Device Removal
  • Embolization, Therapeutic / adverse effects*
  • Embolization, Therapeutic / instrumentation*
  • Equipment Failure
  • Foreign Bodies / surgery*
  • Humans
  • Intracranial Aneurysm / therapy*
  • Jejunal Diseases / etiology*
  • Male
  • Vascular Fistula / etiology*