Percutaneous extraction of an intravascular guidewire retained for 1.5 years

A 47-year-old woman presented with dyspnea. Endovenous laser ablation of varicose veins was performed 1.5 years ago. A linear radiopacity, extended to the external jugular vein, was observed in the right side of the upper mediastinum on posteroanterior chest X-ray (Fig. 1a). A 0.038-inch J guidewire was observed on computed tomography (Fig. 1b). The patient was taken to the catheterization laboratory for percutaneous extraction of the guidewire. The location of the distal part of the guidewire was determined using angiography (Video 1). The guidewire was extended from the inferior vena cava to the right external jugular vein. The snare system was used in an attempt to retrieve the distal part of the guidewire (Video 2). The snare system was advanced into the inferior vena cava through the 6F JR4 catheter and was used in an attempt to retrieve the distal part of the guidewire. Mild resistance was encountered due to adhesions around the guidewire when the snare system was advanced into the inferior vena cava (Video 3). The proximal part of the J guidewire was locked by the EN snare system (Merit Medical, South Jordan, UT, USA) under the endoscope and was extracted through the sheath in the right femoral vein (Fig. 2a). There was no intra- or postoperative complication. Angiographic images were taken after the guidewire was extracted (Video 4). Prior to discharge, her chest X-ray was normal (Fig. 2b).