411 Interv. Cardiol. (2014) 6(5), 411–414 ISSN 1755-5302 part of Interventional Cardiology Case Report 10.2217/ICA.14.43 © 2014 Future Medicine Ltd Guidewire breaking or entrapment during the procedure is a rare but well-reported complication of percutaneous coronary intervention. The entrapped guidewire can be managed through intervention, surgery or conservatively depending upon the clinical situation and position of the guidewire. However, the entrapped guidewire leads to serious complications such as thrombosis, occlusion of the coronary vessel or systemic embolism. As far as the authors’ knowledge is concerned, there is no guideline available for optimal management of entrapped guidewire even though such cases have been reported since the beginning of percutaneous intervention era. Here the authors present a case of hydrophilic guidewire entrapment where a different technique for removal was used. Background Percutaneous transluminal coronary angio- plasty (PTCA) is an effective and relatively safe procedure for the relief of acute coro- nary syndrome. One of the very rare com- plications of PTCA is entrapment of catheter remnants, for example, the guidewire, stent or rotablator in coronary arteries [1] . Cases of fragmentation and entrapment of guidewire have been reported since the beginning of the coronary angioplasty era (in the late 1980s) [2] . Depending upon the clinical situation and the position of the entrapped guide- wire, physicians use different approaches, for example, surgical removal, percutaneous extrication of the guidewire or conservative management. Although few physicians pre- ferred to manage guidewire conservatively (leaving the entrapped guidewire within the coronary bed and following the patients with systemic anticoagulants) [3] , entrap- ment of guidewire in coronary vasculature may lead to thromboembolic occlusion and thereby acute ischemic events in some cases [4] . The authors report here case of a patient who experienced this rare complication of PCI – entrapment of hydrophilic guide- wire after deployment of drug-eluting stents in the left anterior descending coronary artery (LAD). The authors used a different approach for the removal of the stuck guide- wire to avoid post-procedural complications due to remnants of the guidewire. Case report A 41-year-old female attended the clinic with the history of chest pain. She described chest discomfort as being sensation of tightness or squeezing. Hypertension and diabetes, risk factors for developing acute coronary syn- drome, were present in the patient. Evalu- ation of the patient was suggestive of ante- rior wall myocardial ischemia. Coronary angiography (Figure 1A) revealed double vessel disease, 85–90% narrowing of mid LAD, 85–90% narrowing of distal LAD and 85–90% narrowing of long segment of mid right coronary artery. Coronary angioplasty was planned and it was decided to implant drug-eluting stents in the LAD and right coronary artery. Left coronary ostium was selectively engaged by using Launcher ® 6 F (EBU 3.5) guiding catheter (Medtronic Vascular, MN, USA) through right transfemoral route. We attempted to cross the mid-LAD long seg- Successful non-surgical management of entrapped hydrophilic guidewire during percutaneous coronary intervention Sanjay C Porwal* ,1 , Ranjan Modi 1 , Suresh V Patted 1 , Prabhu C Halkatti 1 , Ashok Thakkar 2 & Arohi Sarang 2 1 KLEs Dr Prabhakar Kore Hospital & Medical Research Centre, Belgaum, Karnataka, India 2 Department of Clinical Trials, Sahajanand Medical Technologies Pvt. Ltd., Surat-395004, Gujarat, India *Author for correspondence: Tel.: +91 944 980 0639 drsanjayporwal@gmail.com For reprint orders, please contact: reprints@futuremedicine.com