Surgical release of trapped guidewire after coronary angioplasty and stenting.

摘要

An 81-year-old woman presented with angina. Coronary angiography revealed 95% stenosis of the left anterior descending artery (LAD), before the first diagonal branch. Two guidewires were inserted into the LAD and diagonal, and two stents were advanced into the LAD. At the end of the procedure, the LAD guidewire could be removed easily, but the other one was trapped between the proximal stent and the arterial wall and was impossible to release (Figure 1). Urgent surgical removal was decided, to avoid myocardial infarction. The patient was fully anticoagulated with heparin. After a median sternotomy, cardiopulmonary bypass was instituted at normothermia. The LAD was exposed, the stents were removed from the LAD, and the guidewire was removed from the diagonal branch (Figure 2).