# Retrieving the intravascular ultrasound catheter in the coronary artery by a gooseneck snare: a case report

## TL;DR

A fractured IVUS catheter in a coronary artery was successfully removed using a modified gooseneck snare technique during a heart procedure.

## Contribution

A modified gooseneck snare delivery method is proposed for retrieving fractured devices in tortuous coronary arteries.

## Key findings

- A gooseneck snare was successfully used to retrieve a fractured IVUS catheter from a coronary artery.
- A modified method using the snare catheter as a microcatheter enabled retrieval in a tortuous artery.
- The coronary artery was confirmed uninjured after the retrieval procedure.

## Abstract

Device rupture during percutaneous coronary intervention (PCI) is a rare complication. However, devices remaining in the coronary artery must be removed promptly because they can cause occlusion. We report our success in retrieving a fractured intravascular ultrasound (IVUS) catheter using a gooseneck snare.

A 78-year-old man presented with repeated chest pain on effort. Coronary angiography showed a significant stenosis in the peripheral left circumflex artery (LCX). We performed PCI for this lesion. After pre-dilating the lesion with a balloon, we tried to observe the coronary arterial lumen with an IVUS catheter. At that time, the IVUS catheter was ruptured, and the distal imaging core shaft of it remained in the LCX. We used a gooseneck snare to retrieve it; however, we were unable to advance it to the target site using the conventional method for delivery because of the tortuous LCX. Therefore, we attempted our modified method, using the snare catheter as a microcatheter with a guidewire, to insert the snare wire loop into the target site and successfully retrieved the remaining distal imaging core shaft. After the procedure, we confirmed that the LCX was not visually injured.

Using a snare catheter, such as a microcatheter, is a beneficial option for delivering a gooseneck snare to the target in the coronary artery.