Surgical extraction of occluded stents: when stenting becomes a problem

In this current 'stent era', cardiac surgeons are faced with a rapidly increasing number of patients in whom previous percutaneous coronary interventions (PCIs) have been performed before they are finally referred for coronary artery bypass surgery. We herein describe a technique of surgical revascularization in two patients with diffusely diseased left anterior descending arteries (LAD), covered with multiple overlapping stents extending to their distal portion. The pertinent literature is reviewed and the technical steps and clinical presentation are discussed.