A rare case report: Guiding wire fracture during CT-guided abscess drainage session and subsequent retrieval under fluoroscopy by the endoscopic grasp

Abstract

Guiding wire fractures sometimes occur during cardiological interventional procedures or orthopedic operations, but rarely reported guiding wire fractures during interventional radiological sessions. We present a case of right breast cancer with right axillary nodal metastasis and received surgical resection and neoadjuvant chemotherapy and target therapy. An intramuscular abscess at the right gluteal muscle groups was noted in the contrast-enhanced computer tomography (CT) during her follow up clinic visit. We decided to drain the abscess with CT guiding. A Fr. 10 pig-tail catheter was inserted into the abscess cavity successfully, however, the postprocedure CT found a fragment of the guiding wire retained in the abscess cavity. We exchanged the pig-tail catheter to remove the retained guiding wire and the fragment was successfully retrieved using the endoscopic grasp under fluoroscopy. The fracture event of the guiding wire is rare but may cause severe complications. We identify several considerations that should be aware during the guiding wire usage procedure, and discuss the strategies to manage the condition. The treatment depends on the location of the retained guiding wires, the clinical situation of the patient, and the related complications.

Keywords

• Abscess drainage
• Guiding wire fracture
• Interventional radiology
• Stripped guiding wire