Guidewire entrapment

2. Clinical case presentation
HOW DO WE MANAGE A WIRE ENTRAPMENT
UNPRECEDENTED SITUATION?
HCMC, 8th January, 2023
Dr. Nguyen Thai Yen
Intervention Cardiology Department - Nhan dan Gia Đinh hospital

3. • 73 years old male patient, BMI: 22, with Hypertension, Current Smoking,
Dyslipidemia admitted to our hospital with Moderate chest pain on exertion
for 3 months
• Echocardiography : Lateral wall hypokinesia, LVEF=56%
• Coronary CTA: 50% stenosis at distal LM, 70% stenosis at p-mLAD
Diagnosis:
Stable Angina, CCS class III – Coronary CTA positive – Hypertension – Dyslipidemia

4. Coronary Angiogram
RCA LM-LAD

5. Assessment
• Syntax score : 21
• PCI
• Syntax score II: 27.9
• PCI 4 year mortality: 5.8%
• CABG
• Syntax score II: 35.5
• CABG 4 year mortality: 10.4%
• Treatment recommendation: PCI

6. 7F EBU 7F EBU

7. Runthrough wire to LAD
Sion Blue DG1
Sion to LCx
Biofreedom 2,75x36 mm

8. After stenting LAD Pre-dilate LM
3.0x15 mm NC balloon

9. Stenting LM with Biofreedom 3.5x14 mm After stenting LM

10. Trapped Wire: the wire wasn’t broken instead of lengthen
What should we do?