Migration of a sirolimus-eluting stent from the ostium of the left main coronary artery to the right deep femoral artery

Won, Ki‐Bum; Kim, Byeong Keuk; Ko, Young Guk; Hong, Myeong Ki; Jang, Yang Soo; Shim, Won Heum

doi:10.3904/kjim.2013.28.1.116

Cited by 4 publications

(3 citation statements)

References 5 publications

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“…The utilization of coronary stent has broken new ground in percutaneous coronary intervention (PCI); however, it has also brought new complications to cardiology, like frequent stent restenosis and stent thrombosis and, rarely, stent fracture and stent dislodgement (1)(2)(3)(4)(5). These complications can lead to myocardial infarction, emergency operation, peripheral and cerebral embolism, and even death (2)(3)(4)(5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

“…The numerous limitations of the clinical usage of warfarin have led clinicians to search for alternative agents. New oral anticoagulants (NOACs), such as dabigatran, appear to be preferable in these patients (5,6). Herein, we present a patient with acute ischemic stroke (AIS) occurring under dabigatran treatment, causing fainting, which resulted in a traumatic large lower leg hematoma.…”

Section: Introductionmentioning

confidence: 99%

“…These complications can lead to myocardial infarction, emergency operation, peripheral and cerebral embolism, and even death (2)(3)(4)(5)(6)(7)(8). Retrieving the unplaced stent by pulling away the balloon through a device, like a snare catheter, is a rare case in the literature, but the retraction of a placed intracoronary stent through a jailed guidewire has not, to our knowledge, been presented in the literature yet (5).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Unexpected retraction of an implanted coronary stent

Ayça¹,

Okuyan²,

Şahin³

et al. 2014

Anadolu Kardiyol Derg

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Unexpected retraction of an implanted coronary stent

Ayça¹,

Okuyan²,

Şahin³

et al. 2014

Anadolu Kardiyol Derg

View full text Add to dashboard Cite

Coronary stent dislodgment after deployment during bifurcation treatment with the double kissing crush technique: A case report

Talanas¹,

Lorenzoni²,

Fiore³

et al. 2015

Journal of Indian College of Cardiology

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Letter by Porto et al Regarding Article, “MRI-Induced Stent Dislodgment Soon After Left Main Coronary Artery Stenting”

Porto

Bolognese

Roghi

2014

Circ: Cardiovascular Interventions

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We have read with great interest the case report by Parthasarathy et al 1 describing for the first time a case of MR-induced dislodgement of a coronary stent. Because the implications of attributing such an important complication to the magnetic field are evident (including the risk of negating life-saving imaging to patients), we would like to point out some inconsistencies that we have observed in the article.First, it seems that a nonsignificant stenosis of the left main stem was initially treated with bypass surgery in this patient, because a minimum lumen diameter of 2.5 mm and a minimum lumen area of 5.1 mm 2 are now considered grey-zone values and the lesion was not interrogated for ischemia-inducing potential.2 Subsequently, when the mammary artery graft occluded (possibly due to flow competition), stenting of the same lesion in the body of the left main was undertaken using a 3.5×8 mm Cypher stent (Cordis Corporation/ Johnson & Johnson), probably too short for covering the lesion and the left main ostium, as the operators attempted. In our opinion, additionally, the risk of suboptimal stent apposition to the vessel wall, even after postdilatation with 4.0 mm NC balloon, was high for this thick-strut, closed-cell stent. In agreement with this, minimum lumen diameter in Figure 3F and Figure 3G in that article seems to be <4 mm at visual inspection. In Figure 3H, the stent is seen protruding at least some millimeters in the aorta, leaving little room for coverage of the left main body lesion and for anchorage to the vessel wall. In short, unless more detailed intravascular ultrasound images are provided, and the time elapsed from MR scan to repeat angiography is elucidated, we are inclined to attribute this stent migration more to procedural and mechanical factors than to MR-induced dislodgment. Other cases of migration of short Cypher stents implanted in the left main with optimal results at intravascular ultrasound have been reported and attributed to postimplant stent deformation because of hinge stress, stent shortening by postdilatation, and absent stabilization by the minimal neointimal growth typical of sirolimus-eluting stents. 3As a second point, we would like to stress that all modern stents, including the 316 L stainless steel Cypher (and more so the second-generation, cobalt-alloy drug-eluting stents), have minimal ferromagnetic characteristics. 4 No meaningful effect of the potentially-at-risk 3 T cardiovascular MR on coronary stents has ever been observed, 5 and the 1.5 T magnetic field in this particular patient was focused on the head (and not on the thorax), with remote chances for interaction.In conclusion, we strongly think that even patients with recently implanted ostial drug-eluting stents should not be considered at risk for stent migration with MR based on this report. DisclosuresNone. Italo

show abstract

Migration of a sirolimus-eluting stent from the ostium of the left main coronary artery to the right deep femoral artery

Cited by 4 publications

References 5 publications

Unexpected retraction of an implanted coronary stent

Unexpected retraction of an implanted coronary stent

Coronary stent dislodgment after deployment during bifurcation treatment with the double kissing crush technique: A case report

Letter by Porto et al Regarding Article, “MRI-Induced Stent Dislodgment Soon After Left Main Coronary Artery Stenting”

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