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Case Reports
Published online: 2019-07-02
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Unraveling and Entrapment leading to acute loss of jailed wire and its long term follow-up: case report

Santosh Kumar Sinha, Puneet Aggarwal, Anupam Singh, Kumar Himanshu
DOI: 10.5603/FC.a2019.0078

open access

Ahead of print
Case Reports
Published online: 2019-07-02

Abstract

Jailed wire technique i.e wiring of the side branch (SB) before main vessel (MV) stenting is recommended to keep it open when the SB is deemed important ( > 2mm). Rarely, it becomes difficult to retrieve the jailed wire behind the stent and it may suffer fracture or entrapment, although exceedingly rare. It may be asymptomatic or can lead to abrupt closure of side branch resulting into periprocedural myocardial infarction. Here, we report a case of 56-old male who had undergone percutaneous coronary intervention (PCI) of proximal left anterior descending artery in 2012 during which jailed balance middle weight wire (BMW, Abott Vascular, USA) of diagonal branch got unravelled and entrapped. As patient was asymptomatic, he was conservatively managed. 6-years later, he suffered acute inferior wall myocardial infarction with complete heart block. Primary angioplasty of totally occluded right coronary artery was done with 3x38 mm Xience prime stent (Everolimus eluting stent; Abott vascular, USA). In coronary angiography of left system, left anterior descending and diagonal branches were completely patent. The fractured and retained jailed wire was still in diagonal branch with no displacement in comparison with previous coronary angiography. The patient was discharged in stable cardiac condition with appropriate follow up advise. To the best of our knowledge, this is the longest follow up of entrapped, and fractured BMW wire.

Abstract

Jailed wire technique i.e wiring of the side branch (SB) before main vessel (MV) stenting is recommended to keep it open when the SB is deemed important ( > 2mm). Rarely, it becomes difficult to retrieve the jailed wire behind the stent and it may suffer fracture or entrapment, although exceedingly rare. It may be asymptomatic or can lead to abrupt closure of side branch resulting into periprocedural myocardial infarction. Here, we report a case of 56-old male who had undergone percutaneous coronary intervention (PCI) of proximal left anterior descending artery in 2012 during which jailed balance middle weight wire (BMW, Abott Vascular, USA) of diagonal branch got unravelled and entrapped. As patient was asymptomatic, he was conservatively managed. 6-years later, he suffered acute inferior wall myocardial infarction with complete heart block. Primary angioplasty of totally occluded right coronary artery was done with 3x38 mm Xience prime stent (Everolimus eluting stent; Abott vascular, USA). In coronary angiography of left system, left anterior descending and diagonal branches were completely patent. The fractured and retained jailed wire was still in diagonal branch with no displacement in comparison with previous coronary angiography. The patient was discharged in stable cardiac condition with appropriate follow up advise. To the best of our knowledge, this is the longest follow up of entrapped, and fractured BMW wire.

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Keywords

Entrapment of wire; Jailed wire; Percutaneous coronary intervention; Primary angioplasty; Side branch

About this article
Title

Unraveling and Entrapment leading to acute loss of jailed wire and its long term follow-up: case report

Journal

Folia Cardiologica

Issue

Ahead of print

Published online

2019-07-02

DOI

10.5603/FC.a2019.0078

Keywords

Entrapment of wire
Jailed wire
Percutaneous coronary intervention
Primary angioplasty
Side branch

Authors

Santosh Kumar Sinha
Puneet Aggarwal
Anupam Singh
Kumar Himanshu

References (9)
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