Stent dislodgement induced by a vasodilator used for severe coronary artery spasm caused by Kounis syndrome

Area of Science:

• Cardiology
• Interventional Cardiology
• Medical Device Complications

Background:

• Percutaneous coronary intervention (PCI) is a common procedure for treating coronary artery disease.
• Coronary stent dislodgement is a rare but serious complication following PCI.
• Kounis syndrome, characterized by acute coronary syndrome and mast cell activation, can cause severe coronary artery spasm.

Observation:

• A case of extracoronary stent dislodgement is presented.
• The dislodgement occurred after administration of a vasodilator to manage severe coronary artery spasm.
• The spasm was attributed to Kounis syndrome.

Findings:

• Successful retrieval of the extracoronary dislodged stent was achieved.
• The vasodilator, intended to treat coronary spasm, inadvertently triggered stent dislodgement.
• This highlights a unique mechanism of stent dislodgement in the context of Kounis syndrome.

Implications:

• Successful stent retrieval avoids major adverse cardiac events, such as stent embolization or the need for emergency surgery.
• Understanding this complication can inform clinical practice regarding vasodilator use in patients with Kounis syndrome and PCI.
• This case expands the known spectrum of stent dislodgement etiologies.