Endovascular Retrieval of Unraveled Coils Extending Along the Aorta Due to Guidewire Fracture During Percutaneous Coronary Intervention: The Snare and Trap Technique.

Abstract

Guidewire entrapment and fracture is an uncommon but potentially hazardous event during percutaneous coronary intervention (PCI), and may lead to thrombosis, vessel occlusion, and embolization. In clinical practice interventional cardiologists are aware that such complication is not that rare, especially in complex PCI scenarios. However, its management is still left to the operator's preferences, with individual choices ranging from leaving the fragment in place to urgent cardiac surgery. We report two cases of PCI complicated by entrapment of the guidewire tip, leading to the fracture of the core and subsequent unraveling of the coil that extended deeply along the aorta. Both cases were solved with a novel bailout technique for controlled retrieval of the entire coil filament. The physical bases of such a technique was assessed with laboratory bench tests to extend the reproducibility beyond the two reported cases.