A patient was referred for circumflex PCI. A wire was initially placed in the LAD and upon withdrawal it became entrapped in the left main. Attempts were made to free it up by advancing several balloons and microcatheters all the way to the point of entrapment without success. A second guide catheter was inserted and balloon angioplasty and laser atherectomy were done next to the entrapped wire, again without success. Eventually the wire broke, but the fragment remained entirely within the left main and did not unravel as confirmed by IVUS. The wire fragment was covered with stents and both IVUS and OCT confirmed no protrusion into the aorta.
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Case 88: PCI Manual - Wire entrapment and fracture
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