Abstract
BACKGROUND: Guidewire entrapment in previously stented peripheral vessels is a rare but potentially hazardous complication during percutaneous coronary intervention, particularly in device-related mechanisms involving interaction with implanted metallic structures. CASE SUMMARY: A 70-year-old woman undergoing left main percutaneous coronary intervention developed irreversible entrapment of a 0.014-inch coronary guidewire within a brachiocephalic trunk stent. Conventional radial retrieval failed. A bailout strategy-GRASP (guided retrieval with assisted stent protection)-combining secondary femoral access, balloon-assisted stent anchoring, and simultaneous radial snaring, enabled controlled extraction while preserving stent integrity. DISCUSSION: Device-related entrapment carries increased risk of prosthesis deformation, vascular injury, or material rupture. Balloon-assisted stabilization with bidirectional control may facilitate safe retrieval in complex scenarios. TAKE-HOME MESSAGES: Distinguishing anatomical from device-related entrapment guides management. The GRASP technique may offer a safe bailout option for complex device-related retrieval.