Recovery of a Broken Snare in Coronary Intervention
Arpit Sothwal1, Sandeep Banga1, Abhinav Sood1
1Ascension Borgess Hospital, Michigan State University, Kalamazoo, Michigan, USA.
Insights
Stent loss during coronary intervention is rare. This case details successful retrieval of a dislodged stent and fractured snare using a novel 3-loop system.
Area of Science:
- Interventional Cardiology
- Medical Device Technology
Background:
- Stent loss during percutaneous coronary intervention (PCI) is a rare complication, occurring in approximately 1% of procedures.
- Managing dislodged stents and retrieval devices presents significant procedural challenges.
Background:
Stent loss during percutaneous coronary intervention is a rare but recognized complication, with a reported prevalence of approximately 1%.
Case Summary:
A 63-year-old man with a history of coronary artery bypass grafting was admitted with unstable angina and underwent coronary angiography. Due to significant ostial stenosis of the left circumflex artery (LCX), we elected to treat the lesion with a stent from the left main artery to the LCX. While advancing the stent into the ostial LCX, it became dislodged from the balloon catheter and remained undeployed in the proximal LCX. We attempted retrieval using a micro snare and successfully captured the stent. The distal tip of the snare fractured during withdrawal into the guide catheter. Ultimately, both the dislodged stent and the broken snare were successfully retrieved using a 3-loop retrieval system.
Discussion:
This case underscores the procedural challenges associated with retrieving a dislodged stent and describes strategies for managing both stent and device retrieval.
Take-Home Message:
When resistance is encountered during stent advancement-particularly in vessels with prior stenting, severe calcification, and tortuosity-adjunctive support techniques such as guide extension catheters should be considered to minimize the risk of stent dislodgement and facilitate device delivery.
