Removal of retained intracoronary percutaneous transluminal coronary angioplasty equipment by a percutaneous twin guidewire method.

Balloon rupture during percutaneous transluminal coronary angioplasty (PTCA) resulted in embolization of a guidewire-balloon fragment into the distal circumflex artery. Access to the circumflex was technically difficult because of aortic root dilation. The fragment was removed by inserting two PTCA guidewires into the artery and twisting them together to produce a helix. The helix propagated distally, entrapping the embolized fragment for removal. This report describes an unusual mode of failure for a balloon-on-a-wire dilating catheter and a new percutaneous removal technique that may be applied to retained catheter debris in small, inaccessible vessels.