Stent Damage Associated With a Guide Catheter Extension During Percutaneous Coronary Intervention

In this difficult case of an 80-year-old woman with an acute coronary syndrome and extremely calcified and tortuous left anterior descending artery, the operators were unable to insert the stent into the distal cylinder of the Telescope after encountering strong resistance. Assuming the stent was stuck at the level of the distal cylinder entry pot, they decided to remove both the guide catheter extension (GCE) and the stent as a single unit to prevent complications. Since the first GCE was introduced in 2009, many other GCE systems have been developed and there is accumulating experience with their use. To our knowledge, this is the first description of stent damage occurring during the insertion in the distal cylinder of the Telescope GCE (Medtronic). Interventional cardiologists should always be prepared to face unexpected complications related to sophisticated devices such as GCE.