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Broken guidewire fragment in the radio-brachial artery during transradial sheath placement: percutaneous retrieval via femoral approach.

Kim JY, Yoon J, Jung HS, Kim WJ, Yoo BS, Lee SH, Choi KH - Yonsei Med. J. (2005)

Bottom Line: A case in which a 0.014" wire was broken during the sheath placement in the radial artery for transradial coronary procedure is described here, and a successful retrieval of it using conventional methods is also described.Through the left femoral artery, the 6 Fr guiding catheter was advanced down to the tip of the broken wire at the brachial artery, and the distal part of the broken guidewire was captivated into the guiding catheter.By inflating the balloon catheter inside of the guiding catheter, seized broken guidewire between the inflated balloon and the guiding catheter was removed successfully by withdrawing the whole system en bloc.

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiology, Department of Medicine, Wonju College of Medicine, Yonsei University, 162 Ilsan-dong, Wonju 220-701, Korea.

ABSTRACT
A case in which a 0.014" wire was broken during the sheath placement in the radial artery for transradial coronary procedure is described here, and a successful retrieval of it using conventional methods is also described. Through the left femoral artery, the 6 Fr guiding catheter was advanced down to the tip of the broken wire at the brachial artery, and the distal part of the broken guidewire was captivated into the guiding catheter. By inflating the balloon catheter inside of the guiding catheter, seized broken guidewire between the inflated balloon and the guiding catheter was removed successfully by withdrawing the whole system en bloc.

Show MeSH
A. A broken 0.014" guidewire retained in a left radio-brachial artery. B. Retrieval using a snare was attempted several times but failed. C. The distal part of the broken 0.014" guidewire inside of the guiding catheter. D. Another 0.014" guidewire was passed alongside the broken wire. E. Balloon catheter was positioned alongside the broken wire inside of the distal tip of the guiding catheter. F. Balloon was inflated in the guiding catheter and the guiding catheter was withdrawn.
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Figure 1: A. A broken 0.014" guidewire retained in a left radio-brachial artery. B. Retrieval using a snare was attempted several times but failed. C. The distal part of the broken 0.014" guidewire inside of the guiding catheter. D. Another 0.014" guidewire was passed alongside the broken wire. E. Balloon catheter was positioned alongside the broken wire inside of the distal tip of the guiding catheter. F. Balloon was inflated in the guiding catheter and the guiding catheter was withdrawn.

Mentions: A 68 year old woman had received an intervention with stent at the middle segment of the right coronary artery, and she was scheduled for 6 month follow up coronary angiography in order to evaluate the patency of the stented segment. The previous coronary angiogram and intervention were performed using her right radial artery. Because the right radial artery still had a good pulse according to the positive Allen test, another puncture to the right radial artery was attempted. However, there was difficulty in advancing the 0.035" wire via 20 G catheter needle (Sindongbang Co., Korea) after successful puncture of the right radial artery. In this case, a floppy tip 0.014" wire is passed first into the radial artery through the catheter needle, and the arterial sheath was introduced over the 0.014" guidewire with difficulty. While trying to advance the arterial sheath, the wire was broken (Fig. 1A).


Broken guidewire fragment in the radio-brachial artery during transradial sheath placement: percutaneous retrieval via femoral approach.

Kim JY, Yoon J, Jung HS, Kim WJ, Yoo BS, Lee SH, Choi KH - Yonsei Med. J. (2005)

A. A broken 0.014" guidewire retained in a left radio-brachial artery. B. Retrieval using a snare was attempted several times but failed. C. The distal part of the broken 0.014" guidewire inside of the guiding catheter. D. Another 0.014" guidewire was passed alongside the broken wire. E. Balloon catheter was positioned alongside the broken wire inside of the distal tip of the guiding catheter. F. Balloon was inflated in the guiding catheter and the guiding catheter was withdrawn.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2823045&req=5

Figure 1: A. A broken 0.014" guidewire retained in a left radio-brachial artery. B. Retrieval using a snare was attempted several times but failed. C. The distal part of the broken 0.014" guidewire inside of the guiding catheter. D. Another 0.014" guidewire was passed alongside the broken wire. E. Balloon catheter was positioned alongside the broken wire inside of the distal tip of the guiding catheter. F. Balloon was inflated in the guiding catheter and the guiding catheter was withdrawn.
Mentions: A 68 year old woman had received an intervention with stent at the middle segment of the right coronary artery, and she was scheduled for 6 month follow up coronary angiography in order to evaluate the patency of the stented segment. The previous coronary angiogram and intervention were performed using her right radial artery. Because the right radial artery still had a good pulse according to the positive Allen test, another puncture to the right radial artery was attempted. However, there was difficulty in advancing the 0.035" wire via 20 G catheter needle (Sindongbang Co., Korea) after successful puncture of the right radial artery. In this case, a floppy tip 0.014" wire is passed first into the radial artery through the catheter needle, and the arterial sheath was introduced over the 0.014" guidewire with difficulty. While trying to advance the arterial sheath, the wire was broken (Fig. 1A).

Bottom Line: A case in which a 0.014" wire was broken during the sheath placement in the radial artery for transradial coronary procedure is described here, and a successful retrieval of it using conventional methods is also described.Through the left femoral artery, the 6 Fr guiding catheter was advanced down to the tip of the broken wire at the brachial artery, and the distal part of the broken guidewire was captivated into the guiding catheter.By inflating the balloon catheter inside of the guiding catheter, seized broken guidewire between the inflated balloon and the guiding catheter was removed successfully by withdrawing the whole system en bloc.

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiology, Department of Medicine, Wonju College of Medicine, Yonsei University, 162 Ilsan-dong, Wonju 220-701, Korea.

ABSTRACT
A case in which a 0.014" wire was broken during the sheath placement in the radial artery for transradial coronary procedure is described here, and a successful retrieval of it using conventional methods is also described. Through the left femoral artery, the 6 Fr guiding catheter was advanced down to the tip of the broken wire at the brachial artery, and the distal part of the broken guidewire was captivated into the guiding catheter. By inflating the balloon catheter inside of the guiding catheter, seized broken guidewire between the inflated balloon and the guiding catheter was removed successfully by withdrawing the whole system en bloc.

Show MeSH