Novel Use of Intravascular Lithotripsy for the Mobilization of an Entrapped Coronary Guidewire in a Heavily Calcified LAD/DB Bifurcation Lesion-A Case Report.
Hansmartin Jetter, Jochen Genzel, Wolfram Voelker
✦ AI-curated · Sources linked
Case in brief
A 64-year-old man with NSTEMI had a high-grade proximal and severely calcified mid-LAD lesion near a diagonal branch. During LAD angioplasty and stenting, the jailed diagonal-branch guidewire became trapped behind the stent. Several retrieval maneuvers, including microcatheter assistance, failed. Intravascular lithotripsy was then performed within the stented segment using a balloon advanced over the LAD wire. The trapped wire was subsequently withdrawn easily, and the procedure was completed without further complications.
What made this case unusual
Intravascular lithotripsy was used as a bailout to mobilize a guidewire trapped behind a coronary stent, by fracturing the underlying calcification.
Diagnostic / clinical pearl
When conventional retrieval maneuvers fail for a guidewire trapped behind a stent in a heavily calcified lesion, intravascular lithotripsy may help facilitate withdrawal.