Percutaneous retrieval of a fractured coronary catheter: A case report.

Background: Intravascular angiographic catheter fracture is an extremely rare but critical complication of percutaneous coronary intervention (PCI). Conventional retrieval strategies (e.g., surgical intervention, snares) may prolong procedures and raise peri-procedural complication risks. Herein, we report a case of successful retrieval of a fractured catheter using an innovative technique. Case presentation: A 59-year-old female with 7-year hypertension was admitted for 3-month recurrent exertional angina. Right radial coronary angiography was performed, during which a TIG catheter fractured ∼8 cm proximal to the ulnar-radial bifurcation in the right brachial artery. Initial attempts to retrieve it via a Runthrough NS guidewire failed.To retrieve the fragment, we sequentially advanced JR3.5, 6FBL3.0, and 6FJR3.5 guiding catheters via the right radial arterial sheath to the proximal stump, then tried advancing a Cross-IT XTR guidewire along them-this maneuver remained unsuccessful.Subsequently, an inferior vena cava (IVC) filter retriever via the right radial sheath failed to snare the proximal stump. We then constructed a custom snare by looping a Runthrough NS guidewire at an extension catheter tip, and retrieved the fragment via balloon-assisted counter-traction.Postoperatively, the patient was stable without complications. Dual antiplatelet therapy and follow-up were initiated, with no adverse events at 1-month follow-up. Conclusion: This minimally invasive technique obviates surgery, shows promise for intravascular foreign body management, and provides insights for adapting to failed conventional strategies in complex cases.