Atrapamiento de la guía de angioplastía después de la implantación de un stent: descripción de dos casos y revisión de la literatura / Angioplasty guidewire entrapment affer stent implantation: report of two cases and review of the literature

ABSTRACT

Angioplasty guidewire entrapment, with or without retention of a fractured segment, is an infrequent complication and may lead to acute coronary ischemia due to thromboembolic occlusion. Management can be surgical, conservative or percutaneous. We describe two patients in whom the guidewire remained entrapped with the stent during the pullback maneuver after successful stent implantation. In one patient, we managed to extricate a metallic guidewire using the balloon as a wedge. In the other patient, a fragment of the non-metallic guidewire tip, with hydrophilic coating, remained trapped after being [quot ]cut[quot ] by the stent during traction towards the ostium while attempting removal. The retained segment was isolated from the blood stream by implanting a synthetic coronary stent graft. We emphasize the high risk of [quot ]cutting[quot ] this type of non-metallic guidewire in case of engagement with the stent, and we review the literature of this rare complication.