Bail-Out of Stent Jail: Stent Delivery Through Stent Struts

Stent deployment in a lesion with a large side branch is an example of the potential limitation of intracoronary stents, especially the Palmaz-Schatzª stent with its tubular slotted design. This case study describes a patient in whom a Palmaz-Schatz stent of excessive length covered the origin of a side branch (Òstent jailÓ). Thrombus developed in the jailed branch as well as in the main vessel, causing abrupt vessel closure and impending acute myocardial infarction within one hour after the procedure. This complication was successfully managed by emergency repeat angioplasty and implantation of a Micro Stentª on both branches, i.e. in the main vessel distal to the Palmaz-Schatz stent and in the side branch through the struts of the Palmaz-Schatz stent.