Coronary wire loss: part of jailed wire behind stent struts, protruding in aorta
Coronary guidewire loss complications
Though rare, guidewire loss can occur. When a section of the wire is observed protruding into the aorta behind the stent struts, what techniques and tools do you need to effectively deal with this complication? How do you choose between percutaneous or surgical approaches? Learn more in this section.
Table of content
Introduction
This section explains how wire loss complications should be clinically managed when it has been determined that part of the jailed wire behind the stent struts is protruding into the aorta. Snaring or multiwire techniques are used in retrieving the wire. In the event that this does not work, individualised patient approaches as imaging support are discussed including when – and when not – to choose surgery.
Management overview
- Snare technique (Trifold): The snare technique is often used for the retrieval in cases of inadvertent loss of the guidewire, but involves several decisions and technical steps. Discover more about this technique here.
- Multiwire technique: Guidewire loss during percutaneous coronary intervention (PCI) is explained here with the multiwire retrieval techniques. Retrieval techniques are technically challenging and evidence for their success is limited.
Key messages:
- Evaluate length of wire
- Consider CT scan to identify length of wire
- Individualised patient assessment
- These are pragmatic approaches, data is lacking
Additional links
References - Guidewire loss complications
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