Surgical retrieval of fractured guidewire during percutaneous coronary intervention: A case report

Percutaneous coronary intervention (PCI) is a common treatment for coronary artery disease, but rare complications, such as guidewire fracture, can occur. This report describes a 63-year-old Southeast Asian male with inferior wall myocardial infarction (IWMI) who underwent primary PCI at a secondary care center. While revascularizing the right coronary artery (RCA), the guidewire fractured during left circumflex artery (LCX) stenting. Transferred to a tertiary unit in an unstable condition, redo-angiography revealed the fractured guidewire lodged in the distal left main stem (LMS). After unsuccessful percutaneous retrieval attempts, the patient underwent coronary artery bypass grafting (CABG). The guidewire was successfully retrieved from the LMS and aorta. Although rare, guidewire fractures during PCI can cause severe complications like vessel perforation, thrombus, and embolization. Early detection and management, including surgical intervention when required, are vital to prevent life-threatening outcomes. • We report a fractured guidewire during PCI, which has an incidence rate of only 2 %, requiring surgical intervention. • We successfully retrieved the fractured guidewire surgically after failed percutaneous attempts. • Emphasizes the potential severe complications of guidewire fractures and the importance of timely detection and management. • Demonstrates the importance of transitioning care from interventional cardiology to cardiac surgery in emergencies. • Provides insights into decision-making for conservative versus surgical treatment based on clinical context.