Olgu Sunumu

A case of successful management of a trapped and fractured microcatheter tip during a complex CTO intervention

Cilt: 65 Sayı: 1 9 Mart 2026
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A case of successful management of a trapped and fractured microcatheter tip during a complex CTO intervention

Abstract

Chronic total occlusions (CTOs) represent one of the most technically challenging subsets in coronary artery disease interventions, frequently complicated by severe calcification and difficult vessel anatomy. Microcatheters play a crucial role in CTO percutaneous coronary intervention (PCI), but their use can lead to rare complications such as tip entrapment and fracture, especially in calcified lesions. We present a case of microcatheter tip fracture during complex right coronary artery CTO PCI, managed successfully by employing a parallel-wire technique to bypass the fractured segment followed by stent deployment to crush and trap the fragment against the vessel wall. This approach resulted in complete revascularization without adverse events. The case highlights the importance of understanding device limitations, preparing for procedural complications, and utilizing alternative strategies such as the balloon-assisted sliding technique. As coronary calcification prevalence rises, awareness and effective management of such complications are increasingly critical for optimal patient outcomes.

Keywords

Destekleyen Kurum

The authors received no financial support for the research, authorship, and/or publication of this article.

Etik Beyan

Ethical approval was not obtained because it is a case report.

Kaynakça

  1. Young MN, Secemsky EA, Kaltenbach LA, Jaffer FA, Grantham JA, Rao SV, et al. Examining the operator learning curve for percutaneous coronary intervention of chronic total occlusions: a report from the National Cardiovascular Data Registry. Circulation: Cardiovascular Interventions. 2019;12(8):e007877.
  2. Vemmou E, Nikolakopoulos I, Xenogiannis I, Megaly M, Hall A, Wang Y, et al. Recent advances in microcatheter technology for the treatment of chronic total occlusions. Expert review of medical devices. 2019;16(4):267-73.
  3. Kovacic M, Cocoi M, Leibundgut G. Equipment for Chronic Total Occlusions Percutaneous Coronary Intervention: Present and Future. The American Journal of Cardiology. 2024;232:89-104.
  4. Goel PK, Sahu AK, Kasturi S, Roy S, Shah N, Parikh P, et al. Guiding principles for the clinical use and selection of microcatheters in complex coronary interventions. Frontiers in Cardiovascular Medicine. 2022;9:724608.
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  6. Sadiq MA, Al Riyami AB, Khatri MA, Omar HB. Unexpected Entrapment of Caravel Microcatheter in Percutaneous Chronic Total Coronary Intervention. Sultan Qaboos University Medical Journal. 2024;24(2):300.
  7. Gasparini G-L, Sanz-Sanchez J, Regazzoli D, Boccuzzi G, Oreglia J, Gagnor A, et al. Device entrapment during percutaneous coronary intervention of chronic total occlusions: incidence and management strategies: Device entrapment in chronic total occlusions. EuroIntervention. 2021;17(3):212.
  8. Hashimoto S, Takahashi A, Yamada T, Mizuguchi Y, Taniguchi N, Nakajima S, et al. Usefulness of the twin guidewire method during retrieval of the broken tip of a microcatheter entrapped in a heavily calcified coronary artery. Cardiovascular Revascularization Medicine. 2018;19(8):28-30.

Ayrıntılar

Birincil Dil

İngilizce

Konular

Kardiyoloji

Bölüm

Olgu Sunumu

Yazarlar

Yayımlanma Tarihi

9 Mart 2026

Gönderilme Tarihi

11 Ağustos 2025

Kabul Tarihi

26 Eylül 2025

Yayımlandığı Sayı

Yıl 2026 Cilt: 65 Sayı: 1

DOI

https://doi.org/10.19161/etd.1760727

IZ

https://izlik.org/JA65HX32ZK

Kaynak Göster

RIS / Bibtex
Vancouver
1.Hüseyin Kandemir, Çağlar Alp, Selçuk Öztürk, Nihat Kalay. A case of successful management of a trapped and fractured microcatheter tip during a complex CTO intervention. ETD. 01 Mart 2026;65(1):177-81. doi:10.19161/etd.1760727

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