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After obtaining vascular access, a long 032 guidewire was placed into the svc (superior vena cava).The distal part of the micropuncture sheath broke while removing it from the vasculature over the guidewire.We explored the superficial area along the skin and subcutaneous tissue at the entry site to see if we could identify the distal part and remove it.We were unable to visualize it.We did not see it on fluoroscopy either.I then elected to place a 16 french long sheath over our guidewire.Using the same sheath, i advanced in and snare and grasped the distal end of the j-wire to avoid distal embolization of this.The wire and the snare were simultaneously pulled back into the long 16 french sheath.Once both were well into the sheath, another guidewire was placed to retain access.The sheath, the original 032 guidewire and the snare were all then pulled out of the vasculature.The snare and the original guidewire were then freed up from the remove sheath and we were able to identify the broken fragment of the micropuncture sheath.This was carefully assessed to ensure that the entire fragment was removed without any retained fragments.
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