Balloon Trapping Technique With a Guide Extension Catheter for Retrieval of a Stuck Coronary Guidewire: A Case Report

Guidewire entrapment beneath a coronary stent is an uncommon but potentially serious complication of percutaneous coronary intervention. Forcible traction of the stuck guidewire may cause structural breakdown of guidewire or stent, potentially resulting in thrombus formation or vessel injuries. We report a case of in-stent chronic total occlusion of the left anterior descending artery. After deployment of a drug-eluting stent in the overlapping fashion, the jailed guidewire in a diagonal branch could not be retrieved using standard techniques, such as advancing a microcatheter or small-balloon close to the stent. Therefore, we advanced a 5 Fr guide extension catheter (GEC) over the jailed guidewire, positioning it close to the deployed stent. A balloon catheter was inflated alongside the jailed guidewire to trap and fix it within the GEC. This assembly-guidewire, balloon, and GEC-could be removed smoothly without stent deformation or vessel injury. To our knowledge, this is the first report of entrapped guidewire successfully retrieved with balloon trapping technique using a GEC. This technique provides controlled countertraction, minimizes the risk of complications, and may serve as a reproducible bailout option when conventional methods fail to retrieve the stuck guidewire.