Safe and predictable transcatheter removal of broken coronary guidewires ⏤ the “knuckle-twister” technique – a case series report

Abstract Background Guidewire fracture and loss is a rare but well known feared complication of percutaneous coronary interventions. With the increasing number complex interventions procedures for chronic total occlusions, operators face new challenges boundaries, need solutions to otherwise complications increasing. Case summary We have developed simple practical method retrieving fractured lost guidewires, “knuckle-twister” technique. The following article summarizes seven cases in which guidewires vasculature been successfully removed describes this technique detail. goal was gather different clinical scenarios: free wire situ, jailed behind stent struts, small branches, part protruding into aorta, “invisible” guidewire microfilaments/coils, etc. Discussion innovation knuckle twister consists folding polymer-jacketed transforming it an open lasso that tightens when twisted. In vitro, its grip strength pulling force tested exceeded 1.5 kg. Moreover, all vivo material could be efficiently quite rapidly retrieved with highly reproducible