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CLINICAL IMAGE
Year : 2018  |  Volume : 148  |  Issue : 2  |  Page : 238-239

An unusual case of guide wire fracture during percutaneous transluminal coronary angioplasty


Department of Cardiology, Faculty of Medicine, Ufuk University, Ankara, Turkey

Date of Submission05-Dec-2016
Date of Web Publication19-Oct-2018

Correspondence Address:
Sezen Baglan Uzunget
Department of Cardiology, Faculty of Medicine, Ufuk University, Ankara
Turkey
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmr.IJMR_1951_16

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How to cite this article:
Uzunget SB, Kervancioğlu C. An unusual case of guide wire fracture during percutaneous transluminal coronary angioplasty. Indian J Med Res 2018;148:238-9

How to cite this URL:
Uzunget SB, Kervancioğlu C. An unusual case of guide wire fracture during percutaneous transluminal coronary angioplasty. Indian J Med Res [serial online] 2018 [cited 2020 May 28];148:238-9. Available from: http://www.ijmr.org.in/text.asp?2018/148/2/238/243682

†Patient's consent obtained to publish clinical information and images.


A 64 yr old female patient was referred to the department of Cardiology, Faculty of Medicine, Ufuk University, Ankara, Turkey, with chest pain, in September 2016. A drug-eluting stent (DES) was implanted in the left anterior descending artery (LAD) in another centre a month ago. Coronary angiogram of the left system showed a fractured remnant guide wire extending from the first diagonal ostium to the thoracic aorta [Figure 1], [Figure 2] and (Video). It was decided to catch the distal tip of the remnant wire with loop snare catheter and to retrieve the remnant wire by deep-guide catheter wedge technique (Video). The remnant wire fractured by several attempts and turned to a spiral shape in the proximal part of LAD [Figure 3]. Broken wire parts were removed from the circulatory system. Since this technique failed, by passing through the spiral shape fractured remnant wire, a 3.0 mm×18 mm DES was implanted in the LAD urgently. The mass of the remnant wire was crushed onto the vessel wall (Video). The retained guide wire tip was isolated from the circulation, and post-procedural TIMI (thrombolysis in myocardial infarction) 3 flow was achieved in the LAD (Video). One month later, control coronary angiography was performed and observed normal intracoranary blood flow (Video).
Figure 1: An angiographic image of the fractured wire shows an entrapped guide wire in the left anterior descending. The arrow shows proximal tip of the remnant guide wire.

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Figure 2: The angiography shows the fractured wire in the left anterior descending artery, and the arrows show the extension of the same to the ascending aorta.

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Figure 3: Spiral shape of the remnant fractured guide wire in the left anterior descending artery.

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    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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