Guidewire entrapment is a rare complication of coronary intervention, and management depends on the individual circumstances. This is a case of an urgent percutaneous coronary angioplasty in which a guidewire became entrapped behind a bare metal stent with subsequent fracture of the core filament, which could not be retrieved. Using optical coherence tomography, our case demonstrates extensive tissue coverage of the retained guidewire at twelve months. Five-year follow-up suggests that retained guidewires can be managed without long-term anticoagulation, even when there is substantial intra-aortic material.