Successful Removal of an Entrapped Intravascular Ultrasound Catheter Using a 0.010-inch Guidewire and Compatible Balloon Catheter System

Abstract

Intravascular ultrasound (IVUS) catheter is a user-friendly imaging device widely used during percutaneous coronary intervention (PCI). However, IVUS catheter entrapment is an infrequent but serious complication associated with PCI. Case 1 was an 87-year-old woman on hemodialysis who had non-ST elevation myocardial infarction with total occlusion in the middle left anterior descending artery (LAD). PCI was performed with two drug-eluting stents (DESs) under IVUS guidance, but the IVUS catheter was entrapped at the implanted stent, leading to stent deformation. Case 2 was an 86-year-old woman on hemodialysis who had stable angina with severe calcified stenosis in the middle LAD. IVUS-guided rotational atherectomy was performed, but the IVUS catheter was stuck in the implanted DES with stent deformation. In both patients, we attempted to use a 0.010-inch guidewire and compatible balloon catheter system that can pass through a 6-Fr guide catheter simultaneously with the IVUS catheter, and the entrapped IVUS catheters were successfully removed from the implanted stents. This retrieval method is very convenient to apply during bailout and should be recommended especially in PCI using a 6-Fr guide catheter.