PDF(Pubmed)
Abstract：
BACKGROUND: Guidewire fracture is one of the biggest risks of percutaneous coronary intervention, twisting wire technique is very useful for retrieving the fractured wire, but the potential risks have been inadequately reported. Herein, we present a case of retrieval of guidewire fragments using the twisting wire technique that causes coronary perfusion.
METHODS: A 37-year-old male patient was admitted to our hospital for elective percutaneous coronary intervention of the left circumflex coronary artery.
RESULTS: For chronic total occlusion of the distal left circumflex coronary artery, antegrade recanalization by wire escalation, and parallel wire techniques were attempted. However, we shockingly found that the BMW guidewire, anchored in the right coronary artery, spontaneously fractured from the proximal right coronary artery, and a lengthy fragment of the guidewire remained in the coronary.
METHODS: Many attempts were made to retrieve the remnant guidewire including the twisting wire technique, which leads to the perforation of the coronary.
RESULTS: Finally, percutaneous retrieving procedures were stopped in favor of surgical extraction via a small coronary arteriotomy. This procedure was successful.
CONCLUSIONS: To the best of our knowledge, the present case is the first reported spontaneous fracture of the guidewire. Leaving such a lengthy remnant guidewire in the artery, or leaving stenting over the wire, would impose a high risk of coronary thrombosis, perforation, and embolization. Yet, the perforation of the artery that occurred in this case, which could have had life-threatening consequences, resulted from our attempts to retrieve the guidewire using the twisting wire technique.
METHODS: A 37-year-old male patient was admitted to our hospital for elective percutaneous coronary intervention of the left circumflex coronary artery.
RESULTS: For chronic total occlusion of the distal left circumflex coronary artery, antegrade recanalization by wire escalation, and parallel wire techniques were attempted. However, we shockingly found that the BMW guidewire, anchored in the right coronary artery, spontaneously fractured from the proximal right coronary artery, and a lengthy fragment of the guidewire remained in the coronary.
METHODS: Many attempts were made to retrieve the remnant guidewire including the twisting wire technique, which leads to the perforation of the coronary.
RESULTS: Finally, percutaneous retrieving procedures were stopped in favor of surgical extraction via a small coronary arteriotomy. This procedure was successful.
CONCLUSIONS: To the best of our knowledge, the present case is the first reported spontaneous fracture of the guidewire. Leaving such a lengthy remnant guidewire in the artery, or leaving stenting over the wire, would impose a high risk of coronary thrombosis, perforation, and embolization. Yet, the perforation of the artery that occurred in this case, which could have had life-threatening consequences, resulted from our attempts to retrieve the guidewire using the twisting wire technique.
摘要：
背景：导丝骨折是经皮冠状动脉介入治疗的最大风险之一，绞丝技术对于取回断裂的钢丝非常有用，但是潜在的风险没有得到充分的报告。在这里，我们介绍了一例使用引起冠状动脉灌注的绞丝技术取出导丝碎片的病例.
方法：一名37岁男性患者在我院接受左回旋支冠状动脉择期经皮冠状动脉介入治疗。
结果：对于左旋支冠状动脉远端慢性完全闭塞，通过导线升级的顺行再通术，并尝试了平行线技术。然而,我们震惊地发现宝马导丝，锚定在右冠状动脉，右冠状动脉近端自发骨折，和一个长的片段的导丝留在冠状动脉。
方法：进行了许多尝试来取回残留的导丝，包括绞丝技术，导致冠状动脉穿孔.
结果：最后，经皮取出程序被停止，有利于通过小冠状动脉切开术进行手术摘除。此程序成功。
结论：据我们所知，本病例是首次报道的导丝自发性骨折。在动脉中留下如此长的残留导丝，或者在电线上留下支架，会带来冠状动脉血栓形成的高风险，穿孔,和栓塞。然而，在这种情况下发生的动脉穿孔，可能会有危及生命的后果，由于我们尝试使用扭丝技术取回导丝。
方法：一名37岁男性患者在我院接受左回旋支冠状动脉择期经皮冠状动脉介入治疗。
结果：对于左旋支冠状动脉远端慢性完全闭塞，通过导线升级的顺行再通术，并尝试了平行线技术。然而,我们震惊地发现宝马导丝，锚定在右冠状动脉，右冠状动脉近端自发骨折，和一个长的片段的导丝留在冠状动脉。
方法：进行了许多尝试来取回残留的导丝，包括绞丝技术，导致冠状动脉穿孔.
结果：最后，经皮取出程序被停止，有利于通过小冠状动脉切开术进行手术摘除。此程序成功。
结论：据我们所知，本病例是首次报道的导丝自发性骨折。在动脉中留下如此长的残留导丝，或者在电线上留下支架，会带来冠状动脉血栓形成的高风险，穿孔,和栓塞。然而，在这种情况下发生的动脉穿孔，可能会有危及生命的后果，由于我们尝试使用扭丝技术取回导丝。
