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Case Reports
. 2023 Sep;102(3):495-498.
doi: 10.1002/ccd.30768. Epub 2023 Jul 18.

Management of a broken guiding catheter tip: Cut and fix technique

Navreet Singh  1 , Ajay J Swamy  2 , Nitin Bajaj  1 , Ankush Gupta  1
Affiliations
Case Reports

Management of a broken guiding catheter tip: Cut and fix technique

Navreet Singh et al. Catheter Cardiovasc Interv. 2023 Sep.

Abstract

A 49-year-old male presented with class III exertional angina, 1 year after angioplasty of the left anterior descending artery (LAD) and right coronary artery. Coronary angiogram revealed 90% in-stent restenosis (ISR) in mid-LAD with angiographic impression of stent fracture. Optical coherence tomographic evaluation of mid-LAD ISR showed a distinct 3 mm long "eclipse sign" indicating embolized, broken guiding catheter tip as a cause of ISR, which was confirmed on reviewing 1-year-old angiographic images. This was managed with "cut and fix technique" using cutting balloon and another drug-eluting stent. Optical coherence tomographic at 9 months showed well endothelialized stent with a thin layer of neo-intimal hyperplasia over the sandwiched broken guiding tip.

Keywords: broken catheter tip; cut-and-fix; eclipse sign; optical coherence tomography.

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References

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