Loosen, trap, and pull technique for retrieval of an entrapped stent in a previously stented left main coronary...

Percutaneous coronary intervention (PCI) of left main (LM) bifurcation lesions carries a high risk of complications, including stent entrapment, a rare but potentially life-threatening event. Management often requires surgical intervention, though percutaneous techniques can sometimes provide an alternative solution.

A 63-year-old male with hypertension and diabetes mellitus presented with non-ST elevation myocardial infarction (NSTEMI). PCI was performed using the T and small protrusion (TAP) technique for a 1,1,1 Medina-classified an LM bifurcation lesion. Following deployment of the LM-left anterior descending (LAD) stent, the left circumflex (LCx) stent became entrapped in the LM stent, resulting in fracture and shaft separation during attempted retrieval. A stepwise approach was used: (1) multiple balloon inflations to loosen the entrapped stent; (2) shaft trapping within the guide catheter; and (3) en bloc removal of the system. Final correction included deploying an additional stent to address LM stent deformation. The patient remained stable with no post-procedural complications.

This case highlights the "loosen, trap, and pull" technique as a viable percutaneous alternative for retrieving an entrapped stent within a previously deployed LM stent, potentially avoiding the need for emergent surgical intervention.