Retained guidewire penetrating through the aorta into the thorax: an unusual cause of recurrent bilateral pneumothorax

• Published in: European journal of cardio-thoracic surgery 2016-01, Vol.49 (1), p.e33-e35
• Main Authors: Kim, YongHun, Yu, JunSik, Kim, YoHan, Lee, WooSurng
• Format: Article
• Language: English
• Subjects: Aged; Aorta - injuries; Chest Pain - diagnosis; Chest Pain - etiology; Follow-Up Studies; Foreign-Body Migration - diagnostic imaging; Foreign-Body Migration - surgery; Humans; Male; Pneumothorax - diagnostic imaging; Pneumothorax - etiology; Pneumothorax - surgery; Radiography, Thoracic - methods; Recurrence; Reoperation - methods; Risk Assessment; Stents - adverse effects; Thoracic Surgery, Video-Assisted - methods; Thoracostomy - adverse effects; Thoracostomy - methods; Treatment Outcome; Vertebral Artery - diagnostic imaging; Vertebral Artery - surgery
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1093/ejcts/ezv365

Although numerous complications of the Seldinger technique have been reported in the literature, only a few complications are related to guidewires. We here report a case of a patient with a guidewire lost and retained in the aorta during vertebral artery stenting. Unfortunately, the guidewire in the aorta was not detected for 5 years, and it penetrated through the aorta into the left thorax, leading to recurrent left pneumothorax. No physician identified the wandering guidewire in the left thorax, and the recurrent left pneumothorax was only managed with closed thoracostomy drainage several times. After 4 months, the patient presented to our hospital with repeated severe chest pain, and newly developed right pneumothorax was diagnosed on chest X-rays. We meticulously evaluated the radiological findings of the other hospitals to identify the cause of the recurrent pneumothorax and discovered that the lost and wandering guidewire had crossed over from the left to the right thorax through the anterior mediastinum. The guidewire was identified as the cause of the recurrent bilateral pneumothorax, and the patient was successfully treated with video-assisted thoracoscopic surgery without any events.