A Rare Complication: Hydrophilic Coating of Puncture Guide Wire Found Floating in the Pulmonary Artery

A 62-year-old woman with atrial fibrillation was admitted to Sichuan Provincial People’s Hospital, and radiofrequency ablation therapy was planned. After femoral venous puncture, X-ray fluoroscopy showed a slim-line shaped wire that was floating in the right pulmonary artery (Figure, A; Video 1). To remove the wire, a pigtail catheter was placed in the right pulmonary. Then, the catheter was rotated to pull one part of wire back into the trunk of the right pulmonary. Finally, the wire was successfully captured by a snare (Figure, B; Video 2).

To our surprise, we discovered that this wire was the hydrophilic coating of the puncture guide wire (Figure, C). How has this happened? An inappropriate puncture procedure was considered as the cause of the complication; the interventional physician used a steel puncture needle (ArcRoyal) instead of matched puncture needle (Terumo). When the guide wire was pulled back through the steel needle, the hydrophilic coating may have been stripped (Video 3). In light of this potential complication, physicians should pay close attention when using hydrophilic coating guide wire during vascular puncture.

Affiliations and Disclosures

From the ¹Department of Cardiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; ²WangJiang Hospital, Sichuan University, Chengdu, Sichuan, China.

Acknowledgments: The authors would like to thank Dr. Tao He for supplementing the clinical data. Drs Wang and Zhou contributed equally to the manuscript.

Disclosures: The authors report no financial relationships or conflicts of interest regarding the content herein.

Address for correspondence: Cong Lu MD, No. 32 West Second Section First Ring Road, Chengdu, Sichuan, 610072, China. Email: lucong100@126.com