Hardware Failure as a Rare Complication of Percutaneous Coronary Intervention: A Case Report

Percutaneous coronary intervention (PCI) is increasingly employed in the treatment of complex coronary artery disease. The entrapment or fracture of a coronary angioplasty guidewire is a rare complication of PCI. We herein describe a 61-year-old man who presented with chronic stable angina. The patient's coronary angiogram revealed triple-vessel coronary artery disease, and he was scheduled for primary PCI. During the procedure, the guidewire fractured within the right coronary artery. Despite multiple attempts, the wire could not be retrieved. The wire unraveled in its coils, and its stretching resulted in its eventual snapping in the right radial artery. The initial plan was to attempt guidewire retrieval through a brachial cut-down, and if successful, to manage the obtuse marginal lesion by PCI, thereby precluding general anesthesia and a sternotomy. Unfortunately, the guidewire snapped at the brachial level, necessitating its retrieval by coronary artery bypass surgery. The patient remained asymptomatic and event-free over 6 months of follow-up.