Protected retrieval of a detached iliac branch device nosecone

The detachment of components of endovascular devices is a rare but potentially harmful complication. This report describes a clinical case of nosecone detachment from an iliac branch device delivery system during an aortoiliac aneurysm exclusion in a 73-year-old male patient. After correct deployment, the iliac branch device nosecone detached during the removal of the delivery system. The guidewire was snared from the contralateral side, and two long sheaths were advanced to trap and protect the fractured piece, ensuring nice alignment and enabling its safe removal. This case highlights key strategies for managing serious complications encountered during endovascular aortic repair

Unconventional retrieval of a guidewire fragment from the pulmonary district following retrograde access for chronic limb-threating ischemia

Intraprocedural endovascular device fracture and migration is an uncommon complication, with potential catastrophic outcomes. In a 75-year-old woman, retrograde puncture of the superficial femoral artery led to accidental femoral vein puncture and wire coating fragmentation. The fragment migrated up to a sublobar branch of the left pulmonary artery, and again to the right pulmonary artery during the first retrieval attempt. The final retrieval was performed by twisting three 0.014″ wires around the fragment, together with the support provided by the thromboaspiration Indigo-Penumbra catheter. The triple wire twisting technique supported by an aspiration catheter seems to be safe and effective for this serious pulmonary complication