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Challenges in the Management of Dislodged Coronary Stent Embolization: A Case Report
1Department of Cardiology, Istanbul Medipol University, Istanbul, Türkiye.
Insights
Device embolization during percutaneous coronary interventions (PCI) is a rare but serious complication. This case report emphasizes the need for invasive cardiologists
Area of Science:
- Interventional Cardiology
- Cardiovascular Surgery
Background:
- Device embolization, though rare, poses significant mortality and morbidity risks during percutaneous coronary interventions (PCI).
- Increasingly complex PCI procedures lead to more frequent encounters with device embolization by invasive cardiologists.
- Embolized devices can include stents, guidewire tips, or balloon fragments, necessitating specialized retrieval techniques.
Abstract:
Although device embolization is a rare complication in percutaneous coronary interventions (PCI), its mortality and morbidity are serious complications. With the increasing prevalence of complicated procedures, invasive cardiologists encounter device embolization daily. Different devices and techniques are utilized to retrieve these devices. Most devices used during PCIs are infection stents. More infrequently, the tip of diverting wires, angioplasty balloons, or balloon holders may break and embolize distally into the arteries. A 51-year-old man with non-ST elevation myocardial infarction was presented for restoration of the ring of the stent, which was stripped in the first diagonal ostium, with snare communication. The patient had an anterior myocardial infarction and underwent stent implantation in the left anterior descending artery (LAD) 1 month ago. While the stripped stent was being retracted, the LAD stent had been inserted, causing the stent implanted a month ago to be retracted. Additionally, the dissection was observed in the proximal LAD, and the procedure was terminated by stenting the LAD-Diagonal bifurcation lesion using the mini-crush technique. This case report highlights the importance of constant vigilance that invasive cardiologists must show when removing the embolized device. The maturity of the technique depends on the operator's experience with the methods of use and the material possibilities in the laboratory.
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