Nightmare of Coronary Wire Loop Jail from Side Branch to Main Vessel during Primary Percutaneous Coronary Interventions

Authors

  • Mukesh Kumar National Institute of Cardiovascular Diseases (NICVD), Karachi-Pakistan.
  • Muhammad Naeem Mengal National Institute of Cardiovascular Diseases (NICVD), Karachi-Pakistan.
  • Taimur Asif Ali National Institute of Cardiovascular Diseases (NICVD), Karachi-Pakistan.
  • Tariq Ashraf Karachi Institute of Heart Diseases, Karachi-Pakistan.
  • Rizwan Qurban Ali Khawaja National Institute of Cardiovascular Diseases (NICVD), Karachi-Pakistan.

Keywords:

Guide Wire, Wire Loop Jailing, Coronary Angiography, Percutaneous Coronary Intervention, Left Circumflex Artery, Left Anterior Descending Artery

Abstract

Background: Guide wire breakage and entrapment inside the coronary circulation are rare but extremely dangerous complications of coronary intervention that can be life-threatening by resulting in embolization of thrombi, perforation of the coronary vasculature, and thrombus development.

Case Presentation: A male patient who developed a complication of left circumflex artery guide wire looped and trapped under left anterior descending artery (LAD) stent during Primary PCI and went for emergency cardiac surgery for removal.

Management & Results: Guide wire entrapment during the intervention should always consider this as a risk factor, especially when intervening in the tortuous coronary vasculature, and it is important to keep several wires, snare wires, and a surgical team on board as a backup.

Conclusion: Although guide wire entanglement infrequently occurs during interventions, interventionists should always be on the lookout for it, especially in patients with convoluted coronary arteries. Before working on these patient's coronary arteries, it's essential to have a surgical team, lots of wires, and snare wires on hand. These preventative measures may be effective in reducing death and morbidity under adverse conditions.

References

Kim TJ, Kim JK, Park BM, Song PS, Kim DK. Fatal subacute stent thrombosis induced by guidewire fracture with retained filaments in the coronary artery. Korean Circ J. 2013;43:761e765.

Iturbe JM, Abdel-Karim AR, Papayannis A, Mahmood A, Rangan BV, Banerjee S, et al. Frequency, treatment, and consequences of device loss and entrapment in contemporary percutaneous coronary interventions. J Invasive Cardiol. 2012;24:215e221.

M Al-Moghairi A, S Al-Amri H. Management of retained intervention guide-wire: a literature review. Curr Cardiol Rev. 2013;9(3):260-6.

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Published

01-06-2022

How to Cite

Kumar, M. ., Mengal, M. N. ., Ali, T. A. ., Ashraf, T. ., & Khawaja, R. Q. A. . (2022). Nightmare of Coronary Wire Loop Jail from Side Branch to Main Vessel during Primary Percutaneous Coronary Interventions. Pakistan Journal of Cardiovascular Interventions, 2(1), 35–39. Retrieved from https://www.pjcvi.com/index.php/home/article/view/35