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A Breath Away from Disaster: Successful Management of Coronary Stent Loss During Complex PCI
Andrea Viceré1, David Carrick2
1Center of Excellence in Cardiovascular Sciences, Ospedale Isola Tiberina, Gemelli Isola, Rome, Italy.
Insights
Coronary stent loss during percutaneous coronary intervention (PCI) is rare. This case shows successful retrieval of a dislodged stent using a stepwise bailout strategy, emphasizing procedural patience and problem-solving.
Area of Science:
- Interventional Cardiology
- Cardiovascular Medicine
- Medical Device Complications
Background:
- Coronary stent loss is a rare but serious complication during percutaneous coronary intervention (PCI).
- Complex PCI procedures, especially with calcified lesions and bifurcations, increase the risk of such events.
- Prompt and effective management is crucial to prevent adverse outcomes.
Abstract:
Coronary stent loss is a rare but potentially catastrophic complication of percutaneous coronary intervention (PCI), particularly during complex procedures involving calcified lesions and bifurcations. We report the case of a 74-year-old man undergoing PCI of a subacutely occluded proximal left anterior descending artery, complicated by stent dislodgement following an involuntary deep inspiration by the patient. The stent became partially detached from the delivery balloon and was successfully moved into the radial artery while remaining over the guidewire. A stepwise bailout strategy allowed safe completion of the coronary intervention via secondary access, followed by successful snaring and retrieval of the lost stent. This case highlights the importance of maintaining wire position, procedural patience, and structured problem-solving in managing rare but high-risk intraprocedural complications.
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