When the Shaft Breaks: Managing a Cath Lab Nightmare

Area of Science:

• Interventional Cardiology
• Cardiovascular Surgery

Background:

• A 57-year-old male presented with anterior ST-segment elevation myocardial infarction and cardiogenic shock.
• Severe left main (LM) and triple-vessel disease were identified, precluding surgical intervention due to lack of distal targets.

Observation:

• A stent fracture occurred during LM percutaneous coronary intervention, with the fractured segment dislodged into the aorta.
• The patient required immediate management for this critical intraprocedural complication.

Findings:

• Successful retrieval of the fractured stent shaft from the aorta was achieved using a snare technique.
• Key procedural steps included coronary protection, bailout stenting of the LM artery, and subsequent shaft extraction.

Implications:

• This case highlights a rare complication during LM PCI and presents a successful retrieval strategy.
• The findings underscore the importance of specific techniques, such as snare use and balloon trapping, for managing stent entrapment during complex PCI.