Pressure wire kinking, entanglement, and entrapment during intravascular ultrasound studies: A potentially dangerous complication

The simultaneous use of intravascular ultrasound catheters and sensor-tippe d guidewires is gaining acceptance during coronary interventions as a means to gain further insights on the significance of coronary stenoses. Herein we describe four patients in whom the distal tip of the pressure wire becam e entrapped during an intravascular ultrasound examination. In the four pat ients, a localized kinking of the pressure wire initially prevented the rem oval of the imaging catheter and eventually the wire-catheter assembly had to be retrieved as a unit into the guiding catheter. In one patient, unrave ling of the distal part of the pressure wire was noticed. In two patients, a complete loop with further kinking of the pressure wire was induced durin g the maneuvers performed to withdraw the imaging system. Three patients ex perienced transient angina. Although in our patients this technical problem was not associated with any clinical sequelae, interventional cardiologist s should be aware of the potential complications associated with the combin ed use of these two intracoronary diagnostic tools. (C) 2000 Wiley-Liss, In c.