title: Percutaneous retrieval of a twisted guide catheter using a longer second radial sheath.
abstract: Coronary angiography and percutaneous coronary intervention (PCI) over the radial approach are becoming more frequent and are recommended by the European Association of Percutaneous Cardiovascular Interventions and European Society of Cardiology. The radial approach leads to less bleeding and improved survival in ST-segment elevation myocardial infarction. Pronounced guide catheter manipulation in cases with tortuous access routes and requirement of extra backup during complex PCI may structurally damage the guide shaft and facilitate twisting and bending. We present three cases where a twisted coronary catheter became stuck in the radial artery and describe a minimally invasive retrieval technique using a second introducer sheath of same French (F) size and greater length.
authors.affiliation: Klinik für Kardiologie und Angiologie II, Universitäts-Herzzentrum Freiburg • Bad Krozingen, Bad Krozingen, Germany.
authors.forename: Gregor
authors.initials: G
authors.lastname: Leibundgut
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Löffelhardt
authors.forename: Franz-Josef
authors.initials: FJ
authors.lastname: Neumann
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D062906:Cardiac Catheters; D017023:Coronary Angiography / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000628:therapy*; D020878:Device Removal / Q000379:methods*; D004868:Equipment Failure; D006801:Humans; D008297:Male; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D017534:Radial Artery / Q000000981:diagnostic imaging; D016896:Treatment Outcome
keywords: angiography; guide wire twist; percutaneous coronary intervention