Successful retrieval of an unexpanded coronary stent from the left main coronary artery during primary percutaneous coronary intervention

Šalinger-Martinović, Sonja; Stojković, Siniša; Pavlović, Milan; Perišić, Zoran; Obradović, Slobodan; Apostolović, Svetlana; Zivkovic, Milan; Božinović, Nenad

doi:10.2298/sarh1110669s

Cited by 2 publications

(2 citation statements)

References 5 publications

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“…Therefore, it is more common for complications to occur, such as blood vessel perforation, periprocedural myocardial infarction, and stent slipping. Radiation injuries and contrast-induced nephropathy are also possible due to the length and complexity of the procedure [19,20].…”

Section: Discussionmentioning

confidence: 99%

Recanalization of coronary artery chronic total occlusion by retrograde approach

et al. 2017

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Introduction Chronic total occlusion (CTO) is defined as a 100% obstruction of the blood vessel lumen with Thrombolysis in Myocardial Infarction grade 0 flow in the occluded segment at least three months old. Advancement of technological devices and techniques used during the percutaneous coronary interventions (PCI) in the past years brought more success in blood vessel recanalization. According to the latest guidelines for myocardial revascularization, the CTO treatment should be considered when there are symptoms or objective proof of viability or ischemia in the occluded area. The aim of this work is to present two cases with a recanalization of the coronary artery CTO by the retrograde approach. Outline of cases The first patient had a single vessel coronary disease which led to a decision to first attempt PCI. During the attempt of antegrade recanalization, the guidewire penetrated subintimally, risking blood vessel dissection below the occluded area as well as serious complications. Retrograde approach enabled easier and safer passing of guidewire through the occlusion and then successful establishment of the antegrade flow. In the second case, the antegrade approach was also first attempted. Since it could not pass through the occluded area despite changing several guidewires, the strategy was changed during the intervention. It was continued with the retrograde approach, which led to the successful revascularization. Conclusion These two cases demonstrate that retrograde approach and new technological improvements in dedicated guidewires can be implemented in everyday angiography practice for successful recanalization of CTO lesions.

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Section: Discussionmentioning

confidence: 99%

Recanalization of coronary artery chronic total occlusion by retrograde approach

et al. 2017

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“…The well-described technique of inflating another balloon within the guide catheter to trap the proximal fractured segment against the wall of the guide catheter3 also could have been useful in our case as it would have allowed us to pull back the guide catheter while ensuring that the fractured balloon travelled with it. Another percutaneous option available was the Fogarty technique involving passing another balloon distal to the entrapped balloon and then inflating this at a low pressure, then withdrawing slowly so as to retract the entrapped balloon 1 11. The fact, however, that our balloon was inflated to approximately three quarters its nominal volume would have made negotiating another balloon distal to it difficult.…”

Section: Discussionmentioning

confidence: 99%

Fracture, inflation and floatation embolisation of PTCA balloon

2015

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SUMMARYThis case outlines an unusual complication of coronary intervention, the likely mechanisms leading to this and possible retrieval options. It is the first case to the best of our knowledge reporting this complication. A 78-yearold Caucasian man underwent coronary stenting. During the procedure kinking and subsequent fracture of a non-compliant percutaneous transluminal coronary angioplasty (PTCA) balloon occurred. Injection of contrast down the guide to opacify the coronary arteries resulted in 'inflation' of the balloon with air, and embolisation of the inflated balloon into the proximal left anterior descending artery. The embolised balloon was retrieved by removal of the guide catheter and wire as a unit. The patient had a good angiographic outcome. This case highlights risks associated with usage of kinked balloons catheters, and describes for the first time to our knowledge, the inflation of a PTCA balloon with air from its shaft within the catheter, causing 'floatation' embolisation into the coronary artery. BACKGROUND

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Successful retrieval of an unexpanded coronary stent from the left main coronary artery during primary percutaneous coronary intervention

Cited by 2 publications

References 5 publications

Recanalization of coronary artery chronic total occlusion by retrograde approach

Recanalization of coronary artery chronic total occlusion by retrograde approach

Fracture, inflation and floatation embolisation of PTCA balloon

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