Percutaneous Stentectomy: Extraordinary Problems Require Extraordinary Solutions

An 89-year-old woman was referred for transcatheter aortic valve replacement (TAVR). She had a history of ostial right coronary artery stent that was protruding into the aorta with the risk of interaction with the TAVR prosthesis.

Using femoral arterial access, a Goose Neck snare was advanced and captured the overhanging part of the stent. The stent was successfully retrieved, followed by restenting of the ostial right coronary artery with intravascular ultrasound guidance.

There are only a few case reports of percutaneous removal of deployed stents, whether accidentally or intentionally. Intentional removal of deployed stent is feared given the possibility of severe complications, and most patients who require such intervention are referred to surgery.

Percutaneous removal of protruding coronary stents is technically feasible. This case demonstrates that snare-based retrieval is a practical solution when aorto-ostial stent protrusion threatens both coronary and structural interventions.