Document Type : Case Report
1 Professor, Department of Cardiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 MD, Cardiologist, Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
The patient is a 65 year old male,7 years earlier while the patient was in excellent medical condition without any risk factor for coronary artery disease except cigarette smoking the patient developed extensive ant MI. Coronary angiography at that time revealed severe(90%) stenosis of LAD mid portion, significant stenosis of LAD distal portion and significant stenosis of origin of diagonal branch. Plain balloon angioplasty of diagonal branch and predilation and stenting of LAD mid portion was planned in another session. two 0.014 guidewire were inserted in LAD and Diagonal branches. Plain balloon angioplasty of diagonal branch was done using 2.0-20 balloon. Then LAD distal lesion was opened by 3 15 balloon using nominal atmosphere pressure. LAD proximal lesion was primarily predilated with 3.0 14 balloon and then stented with 3.0 -15 stent at 16 atmosphere pressure. In final angiogram both LAD and diagonal branches were completely open. But at the end of procedure while pulling back the guide wires from the coronary arteries, Diagonal guide wire was trapped and it’s distal ,radiopaque segment was separated and remained behind the LAD stent(fig 1). Since the patient hemodynamic condition was stable and the retained guidewire did not impair blood flow in LAD or Diagonal branch no further action was made and the patient was sent to post cath unit. The patient was discharged home the day after.