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

Le résumé fourni par la source

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.

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