Navigating an Entrapped Guide Wire in RCA CTO PCI: A Case Report

Background: Guide wire fracture and entrapment during coronary intervention are rare but serious complications. These incidents can lead to thromboembolism, vessel perforation, and thrombosis, necessitating immediate and careful intervention. Case Report: We present a case involving a male patient undergoing PCI for a chronic total occlusion (CTO) of the right coronary artery (RCA), where a guide wire became entangled and entrapped under a deployed stent, requiring complex percutaneous techniques. Despite prolonged efforts using multiple retrieval strategies, the wire fractured. The remnant was securely embedded with a stent and post-dilated. The patient recovered without event. Conclusion: Entrapped guide wires represent a rare yet serious complication in PCI. When extraction is unfeasible, stenting over the remnant with adequate post-dilation is a viable and safe alternative.