Retrieval of undeployed intracoronary Palmaz‐Schatz stents

Abstract

Two patients undergoing stent placement with the Palmaz-Schatz coronary stent delivery system experienced intracoronary stent embolization. Using a two-wire technique, the stents were successfully removed from the coronary circulation, and this allowed completion of the percutaneous revascularization procedure without any clinical sequelae. These two cases represent the first report of successful percutaneous retrieval of undeployed, retained intracoronary Palmaz-Schatz stents.

Intracoronary loss of balloon-mounted stents: Successful retrieval with a 2 mm-“Microsnare”-device

“…The technique we describe in this article may prove advantageous compared to that recently proposed in this journal [5] in several respects: the closed-loop design and the small loop diameter make distal dislocation of the stent, once captured, highly unlikely; peripheral embolization can most probably be avoided if a Microsnare device is used, allowing a more secure direct retrieval through the femoral sheath. Although peripheral embolization of stents may not always be accompanied by clinical sequelae [6], a complete removal of misplaced foreign objects from the human body is clearly to be desired.…”

“…Preferred procedures vary from laboratory to laboratory. Methods for stent-retrieval described in the literature so far involve the usage of biliary or bioptome forceps catheters [7,9,11], balloon catheters [ 141, multipurpose baskets [ 111, standard (large loop) snare catheters [8,11], two twisted guidewires [lo] or a self-assembled loop made of a second guidewire [5,6].…”

“…Intracoronary misplacement of a stent during percutaneous interventions may prove hazardous to the patient as well [2] and may even necessitate emergency cardiothoracic surgery [4]. Dislocation of coronary endoprotheses may occur despite technical improvements, e.g., the development of "protected" stents, covered by a retractable sheath [5]. Procedures have been described for extraction of undeployed stents from the systemic vasculature [6-81 and a few reports have documented successful removal from the coronary circulation [5,9-1 I].…”

Unexpanded, irretrievable stent in the proximal right coronary artery: Successful management with stent graft implantation

“…Kobayashi et al [3] have written about their successful retrieval of a PS stent with the gooseneck snare device from the left main coronary artery. Other authors have reported on a special two-wire technique that allows retrieval of the coronary stents without any complications [5] or fixation and removal of the undeployed stents during CABG or from the sheath in the femoral artery, respectively [6]. Further applications include balloon inflation distal to the stent [7] as well as the use of a low-profile balloon catheter together with 6 Fr biopsy forceps to catch and pull back a lost stent from the descending aorta [8].…”

Embolised Stent Into the Circumflex Coronary Artery During Percutaneous Coronary Intervention

“…They were not rare when using first generation stents. [1][2][3] Most new interventional cardiologists have not commonly encountered these complications because the new generation of stents are often not attached to a balloon.…”