An unusual cause of guide wire fracture during percutaneous
The following case has been reported in the Indian Journal of Medical Research.

A 64 yr old female patient was referred to the department of Cardiology with chest pain. A drug-eluting stent (DES) was implanted in the left anterior descending artery (LAD) in another centre a month ago. Coronary angiogram of the left system showed a fractured remnant guide wire extending from the first diagonal ostium to the thoracic aorta.

It was decided to catch the distal tip of the remnant wire with loop snare catheter and to retrieve the remnant wire by deep-guide catheter wedge technique. The remnant wire fractured by several attempts and turned to a spiral shape in the proximal part of LAD. Broken wire parts were removed from the circulatory system.

Since this technique failed, by passing through the spiral shape fractured remnant wire, a 3.0 mm×18 mm DES was implanted in the LAD urgently. The mass of the remnant wire was crushed onto the vessel wall. The retained guide wire tip was isolated from the circulation, and post-procedural TIMI (thrombolysis in myocardial infarction) 3 flow was achieved in the LAD.

One month later, control coronary angiography was performed and observed normal intracoronary blood flow (Video available).

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