# Successful Management of Coronary Guidewire Fracture Using Intravascular Ultrasound—Guided Stent Jailing Technique During Retrograde Chronic Total Occlusion Recanalization

## TL;DR

This paper describes a successful technique using intravascular ultrasound to manage a fractured guidewire during a complex heart procedure.

## Contribution

The novel use of intravascular ultrasound-guided stent jailing to manage guidewire fractures during retrograde chronic total occlusion recanalization is highlighted.

## Key findings

- Intravascular ultrasound effectively assessed the length of the retained guidewire.
- Stent jailing successfully secured the fractured guidewire filament into the vessel wall.
- The technique proved useful when percutaneous retrieval attempts failed.

## Abstract

Retrograde recanalization of chronic total occlusion can be challenging for its association with a greater risk of device entrapment and fracture. Aggressive advancement of retrograde guidewire through tortuous collateral may increase the risk of guidewire fracture. Stent jailing technique can sometimes be adopted based on the location, length, and morphology of the fractured guidewire when the patient was clinically stable and percutaneous attempts failed to retrieve. Intravascular ultrasound plays a critical role in assessing the length of the retained guidewire and guiding the final stenting to jail the wire filament into the vessel wall.