10 April 2026
: Case report 
Guidewire Traction Retrieval of a Dislodged Classic Crown During Coronary Orbital Atherectomy
Diagnostic / therapeutic accidents
Yutaro Ota ABDEF 1*, Takaaki Kitayama B 1, Shunsuke Sato B 1, Naoki Nishimura B 1, Tsubasa Yamamoto B 1, Hirotaka Yamanaka B 1, Hirotaka Momose B 1, Shinya Yamazaki B 1, Takashi Yanagiuchi B 1, Youhei Fushimura B 1, Shumpei Ushimaru B 1, Ritsuko Kurimoto B 1, Hiroki Mani B 1, Hirokazu Yokoi ABE 1DOI: 10.12659/AJCR.952154
Am J Case Rep 2026; 27:e952154
Figure 1 (A) Baseline right coronary artery (RCA) angiogram with corresponding intravascular ultrasound image of the target lesion. (B) Fractured orbital atherectomy crown lodged at an angulated segment. (C) Unsuccessful attempt with a 4-mm Amplatz Goose Neck snare; unable to traverse the tortuous, calcified proximal RCA. (D) Unsuccessful anchor-balloon technique with a 7-Fr Telescope guide extension; a rigid calcified bend prevented advancement. (E) Successful guidewire traction retrieval: gentle traction on the ViperWire Advance Flex Tip, with buddy wire support, drew the crown en bloc into the guiding catheter. (F) Retrieved crown on the ViperWire Advance Flex Tip. (G) Deployment of a XIENCE Sierra 2.5×18 mm drug-eluting stent aligned to the RCA ostium. (H) Final angiogram. Yellow arrows denote the fractured crown.