Korean Circ J.  2010 Sep;40(9):475-477. 10.4070/kcj.2010.40.9.475.

A Case of Guide Wire Fracture With Remnant Filaments in the Left Anterior Descending Coronary Artery and Aorta

• Hong YM
• Lee SR

• KMID: 1456143
• DOI: http://doi.org/10.4070/kcj.2010.40.9.475

Abstract

Guide wire fractures during percutaneous coronary intervention (PCI) are very rare, but when they do occur they may lead to life-threatening complications, such as embolization, thrombus formation and perforation. In cases when percutaneous retrieval has failed, surgical extraction of the remnant fragments is recommended. We present a case of remnant guide wire filaments that remained in place without complications, over a one-year clinical follow up period.

Keyword

Percataneous transluminal coronary angioplasty; Coronary artery disease

MeSH Terms

Aorta
Coronary Artery Disease
Coronary Vessels
Follow-Up Studies
Hypogonadism
Mitochondrial Diseases
Ophthalmoplegia
Percutaneous Coronary Intervention
Thrombosis
Hypogonadism
Mitochondrial Diseases
Ophthalmoplegia

Figure

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  Fig. 1 A diagnostic coronary angiogram showed diffuse and significant stenosis from the proximal to middle LAD (arrow head) and first diagonal branch (arrow head) (A and B). After deployment of two sirolimus-eluting stents over the LAD, a fracture occurred at the distal tip of the BMW guide wire (arrow) (C and D). LAD: left anterior descending coronary artery, BMW: Balance Middleweight.

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  Fig. 2 A fracture occurred at the distal tip of the BMW guide wire (white arrow). In addition, un-coiled filaments of the BMW guide wire were left in situ (arrow head). BMW: Balance Middleweight.

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  Fig. 3 Two-dimensional echocardiography showed string-like echogenicity from the ascending aorta (arrow) to the aortic arch (arrow head).

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  Fig. 4 Remnant guide wire filaments were located from the coronary artery to the aortic arch. LAD: left anterior descending coronary artery, LCX: left circumflex coronary artery, LM: left main coronary artery, RCA: right coronary artery.

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