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Damage to a covered stent by a thrombectomy device.
Gordon Pate1, Ronald Carere, John Webb
1Division of Cardiology, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
Summary
A covered stent procedure for coronary artery stenosis led to graft thrombosis and device malfunction. Caution is advised when using the X-Sizer device with covered stents.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Biomedical Engineering
Background:
- Coronary artery bypass grafting (CABG) is a common procedure for treating coronary artery disease.
- Vein graft stenosis can lead to graft failure and adverse cardiac events.
- Covered stents offer a solution for complex graft lesions but may present unique challenges.
Observation:
- A 75-year-old patient with a history of CABG developed acute inferior myocardial infarction.
- Significant stenosis in a right coronary artery vein graft was treated with a Symbiot covered stent.
- The graft thrombosed the following day, necessitating intervention.
Findings:
- Thrombectomy using an X-Sizer device caused damage to the polytetrafluoroethylene (PTFE) stent lining.
- The device jammed, requiring removal of a piece of the stent covering.
- A subsequent stent deployment within the damaged stent was performed for treatment.
Implications:
- The X-Sizer device may cause complications when used with covered stents.
- Careful consideration and potential avoidance of this thrombectomy device in covered stent procedures are warranted.
- Further research is needed to evaluate the safety and efficacy of thrombectomy devices in conjunction with covered stents.