Guidewire Entrapment During Percutaneous Intervention for Chronic Total Occlusion: A Rare Case Report

Abstract

Iatrogenic complications occur in approximately 0.21% of percutaneous coronary interventions (PCI), which are critical for diagnosing and treating acute coronary syndrome. This case report details a rare complication involving guidewire entrapment during a PCI procedure for chronic total occlusion (CTO). A 71-year-old male with a diagnosis of myocardial infarction (MI) was admitted to the catheterization laboratory, where imaging revealed total occlusion of the Left Anterior Descending (LAD) artery. During the intervention, a balloon shaft breakage prevented the stent balloon from being withdrawn, necessitating an emergency surgical intervention. The guidewire was successfully removed, and urgent revascularization was performed through coronary artery bypass grafting (CABG). The patient experienced a stable recovery, being discharged after one week of intensive care unit monitoring and five days of ward observation. This case highlights the potential for severe complications in CTO interventions and suggests that pre-intervention consultation between cardiology and cardiovascular surgery teams could mitigate such risks and improve outcomes.