We report an extremely rare case of gooseneck snare-assisted retrieval of an embolized coronary guidewire from the aortic arch in an elderly male scheduled for a transradial coronary angiogram for unstable angina. In this case, the proximal end of the embolized coronary guidewire could not be retrieved from the brachial artery nor the roomy aortic root using a flower petal snare. The key takeaway from this case is that an embolized coronary guidewire can be successfully retrieved with a gooseneck snare from its proximal end in a moderately spacious area like the aortic arch.
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http://dx.doi.org/10.7759/cureus.59707 | DOI Listing |
Case Rep Cardiol
December 2024
Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
A 48-year-old male with a history of hyperlipidemia presented to the emergency department with chest pain. Electrocardiographic abnormalities indicated an acute coronary syndrome. Urgent coronary angiography revealed nondominant right coronary artery (RCA) occlusion.
View Article and Find Full Text PDFCureus
November 2024
Internal Medicine, St Johns Hospital, Livingston, GBR.
Iatrogenic type A aortic dissection (IAAD) is a rare but life-threatening complication of percutaneous coronary intervention (PCI), often presenting significant therapeutic challenges. A looped guidewire between the right subclavian artery and brachiocephalic artery during coronary angiography (CAG) via right radial artery access can complicate catheter manipulation. This report discusses the case of a 58-year-old hypertensive female patient who developed aortic dissection during PCI, specifically due to wire manipulation at the brachiocephalic loop.
View Article and Find Full Text PDFJ Cardiol Cases
December 2024
Department of Cardiology, Asia Medical Group, Sapporo Heart Center, Sapporo Cardio Vascular Clinic, Sapporo, Japan.
Unlabelled: Persistent sciatic artery (PSA) is a rare congenital anomaly that may involve aneurysmal formations. During endovascular treatment for PSA aneurysm (PSAA) occlusion, guidewire crossing can be challenging due to complex anatomy. We report successful endovascular intervention for PSAA occlusion using the "direct tip injection in occlusive lesions (DIOL)" fashion, in which hydraulic pressure with contrast facilitates guidewire crossing by visualizing the vessel course and expanding the microchannel and vessel lumen.
View Article and Find Full Text PDFCatheter Cardiovasc Interv
December 2024
Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, Opole, Poland.
Predicting coronary artery occlusion after transcatheter aortic valve replacement (TAVR) is usually based on computed tomography angiography (CTA). The primary risk factors seem to be a low coronary artery take-off and a small aortic root. However, CTA sometimes provides ambiguous risk assessment, and even if a potentially risky coronary artery is secured with a guidewire, the need for coronary stenting after valve implantation often remains uncertain.
View Article and Find Full Text PDFPediatr Cardiol
December 2024
Emeritus, UC San Diego School of Medicine, 9640 Deer Trail Drive, San Diego, CA, 92127, USA.
This article provides a historical review and a current perspective on the procedures used to palliate cyanosis in ductal-dependent infants. Eighty years ago, Helen Taussig, Alfred Blalock, and Vivien Thomas developed the first effective treatment. The Blalock-Taussig-Thomas (BTT) shunt is the historical predecessor of both the contemporary-modified BTT shunt and interventional stenting of the Patent Ductus Arteriosus (PDA).
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