Korean J Radiol.  2011 Oct;12(5):638-640. 10.3348/kjr.2011.12.5.638.

Guidewire Breakage during Neurointerventional Procedures: a Report of Two Cases

• Lee MS
• Whang K
• Kim HJ
• Kwon OK
• Brain Research Group

• KMID: 1116452
• DOI: http://doi.org/10.3348/kjr.2011.12.5.638

Abstract

We report on two cases of microguidewire breakage that occurred during endovascular treatment of intracranial aneurysms. The microguidewire can be broken when a part of the wire is stuck due to vascular tortuosity, and, subsequently, application of excessive rotational movement. The mechanical and physical properties of a microguidewire are also important factors in microguidewire breakage. We also suggest technical tips for avoidance of this problem.

Keyword

Aneurysm; Microguidewires; Mechanical properties

MeSH Terms

Aged
*Catheters
Device Removal
Embolization, Therapeutic/*instrumentation
*Equipment Failure
Female
Humans
Intracranial Aneurysm/*therapy
Middle Aged
Radiography, Interventional/*instrumentation

Figure

• 

  Fig. 1 Guidewire breakage during neurointerventional procedures in 47-year-old woman. A. Fractured guidewire within internal carotid artery lumen. Proximal part of fractured guidewire can be seen at abrupt turning point of cervical to petrous internal carotid artery (arrow). B. Retrieved fractured guidewire. Fractured distal segment approximately 9 cm long can be seen.

• 

  Fig. 2 Guidewire breakage during neurointerventional procedures in 65-year-old woman. A. Fractured guidewire within internal carotid artery lumen. Fractured proximal tip of guidewire (arrow) appears to be stuck in wall of tortuous internal carotid artery. B, C. Experimental magnification view showing twisted (B) and fractured (C) guidewire (Transend 014, Boston Scientific, MA; 0.37 mm outer diameter) using stereoscope. In C, outer sheath has been partially removed to show inner metal core.

Reference

1. Stellin G, Ramondo A, Bortolotti U. Guidewire fracture: an unusual complication of percutaneous transluminal coronary angioplasty. Int J Cardiol. 1987. 17:339–342.

2. Sethi GK, Ferguson TB Jr, Miller G, Scott SM. Entrapment of broken guidewire in the left main coronary artery during percutaneous transluminal coronary angioplasty. Ann Thorac Surg. 1989. 47:455–457.

3. Kilic H, Akdemir R, Bicer A. Rupture of guide wire during percutaneous transluminal coronary angioplasty, a case report. Int J Cardiol. 2008. 128:e113–e114.

4. Ceschinski H, Henkes H, Weinert HC, Weber W, Kuhne D, Monstadt H. Torquability of microcatheter guidewires: the resulting torsional moment. Biomed Mater Eng. 2000. 10:31–42.