Finding Safe Haven for a Migrated Left Main Coronary Stent: A Novel Bail Out Technique
Azhar Farooqui1, Omar Bajmmal2, Mohsin Farooq1
1Department of Cardiology, Kettering General Hospital, Kettering, United Kingdom.
Insights
A dislodged drug-eluting stent during percutaneous coronary intervention of the left main stem (LMS) was successfully retrieved using a balloon technique. This case highlights a rare complication and its management in complex coronary interventions.
Area of Science:
- Interventional Cardiology
- Cardiovascular Medicine
- Medical Device Technology
Background:
- Percutaneous coronary intervention (PCI) is a common treatment for coronary artery disease.
- Left main stem (LMS) interventions pose unique challenges due to anatomical complexity and hemodynamic significance.
- Stent maldeployment and embolization are rare but serious complications during PCI.
Abstract:
We describe a case of left main stem (LMS) stent dislodgement and embolization over the guide catheter after an intravascular ultrasound-guided percutaneous coronary intervention to an LMS osteal stenosis. After the initial intravascular ultrasound-guided assessment, the patient underwent percutaneous coronary intervention with 2 overlapping drug-eluting stents. After post-dilation, it was observed that the proximal LMS stent had migrated over the guide catheter proximally and dislodged from its original deployment in the LMS. A 6.0-mm balloon was inflated at the distal end of the guide catheter to prevent stent embolization. The catheter was carefully retrieved until the brachial artery, where the preexpanded stent diameter prevented further retrieval. It was eventually deployed with no immediate complications.
