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Extraction of a Fully Deployed Coronary Stent during Retrieval of Another Dislodged Stent
Jongmin Hwang1, Kook-Jin Chun1, Dae Sung Lee1
1Cardiovascular Center, Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, Korea.
Insights
Coronary stent dislodgement is a rare complication. This case demonstrates successful retrieval of an entrapped, fully deployed stent, highlighting the importance of operator understanding for managing complex percutaneous coronary intervention scenarios.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Device Complications
Background:
- Coronary stent dislodgement is a rare but serious complication during percutaneous coronary intervention (PCI).
- Successful stent retrieval is crucial for patient prognosis, often necessitating intervention.
- Managing dislodged stents, especially when entangled with deployed stents, presents significant challenges.
Purpose of the Study:
- To report a rare case of coronary stent dislodgement with complex entanglement.
- To illustrate the successful retrieval of both a dislodged and a fully deployed coronary stent.
- To emphasize the critical role of operator expertise in managing such challenging PCI complications.
Main Methods:
- A patient presented with a dislodged coronary stent.
- Percutaneous extraction was attempted for the dislodged stent.
- The dislodged stent was found to be entangled with a previously deployed stent.
- Both stents were successfully retrieved as a last resort.
Main Results:
- The dislodged coronary stent was successfully retrieved.
- The entangled, fully deployed coronary stent was also successfully extracted.
- No immediate complications were reported following the dual stent extraction.
- The procedure was successful despite the inherent risks of extracting a deployed stent.
Conclusions:
- Complex coronary stent dislodgement with entanglement is a rare but manageable event.
- Successful extraction of a deployed stent is possible with thorough understanding of the situation.
- Operator experience and careful assessment are paramount in achieving favorable outcomes in challenging PCI cases.
Abstract:
Coronary stent dislodgement is a rare and serious complication of percutaneous coronary intervention and is associated with major adverse cardiac events. Successful retrieval of the stent is recommended in this situation because it is important for the prognosis. Recently, a patient was referred to our hospital with a dislodged coronary stent. When attempting to percutaneously extract the dislodged stent, a challenging situation was encountered, as the stent was entrapped and tightly entangled with another fully deployed coronary stent. Extraction of a fully deployed stent is generally prohibited as it may result in severe complications. Nevertheless, we extracted both the dislodged stent and the fully deployed stent, as a last resort. Herein, we report about this case. Our case highlights if the operator had a thorough understanding of the surrounding circumstances regarding the fully deployed coronary stent, successful extraction of the fully deployed coronary stent without any complications could be possible.
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