Key result
IVUS-guided gooseneck snare retrieval successfully removes a retained coronary guidewire fragment without altering stent position.
Why the study?
Guidewire fracture during PCI is a rare complication that can cause thrombosis, embolism, vessel injury, or myocardial ischemia.
Case Report (n=1)
No
Real-time IVUS visualization can safely guide the percutaneous retrieval of retained guidewire fragments, potentially avoiding the need for surgical intervention.
Answers are grounded in this paper and cite their sources.
May support IVUS-guided snare retrieval to avoid surgery in select cases; leaves open need for prospective validation.
Percutaneous coronary intervention is generally safe, but rare complications such as guidewire fracture can occur and may lead to thrombosis, embolism, vessel injury, or myocardial ischemia. We report the case of a 58-year-old male patient with 2-vessel coronary artery disease who underwent coronary stenting of the left anterior descending and circumflex arteries in another institution. During the index procedure, the guidewire fractured at the bifurcation between the left anterior descending artery and the first diagonal branch. One week later, the patient presented at our institution with recurrent chest pain and a second procedure was performed to retrieve the retained fragment. Real-time intravascular ultrasound imaging was used to visualize the fragment and perform targeted retrieval using a gooseneck snare introduced into the vessel. The fragment was successfully removed without altering the stent position, with uneventful follow-up. This case highlights that real-time IVUS visualization can modify procedural strategy for such complication by improving localization of retained intravascular material and allow safer percutaneous retrieval compared with fluoroscopy alone, potentially reducing the need for surgical intervention.
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Dimdie et al. (2026) conducted a case report in Retained coronary guidewire fragment (n=1). Real-time IVUS-guided retrieval using a gooseneck snare was evaluated on Successful removal of the fragment. Real-time IVUS-guided retrieval using a gooseneck snare successfully removed a retained coronary guidewire fragment without altering stent position.
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