Undermining and Ballooning the Proximal Part of the Left Main Coronary Artery Stent Resulting in an Iatrogenic Stent Deformation

Jeong, Han Saem; Hong, Soon Jun; Hwang, Sung Ho; Ko, Kyoung Ho; Hwang, Tae Yeon; Yu, Cheol Woong; Lim, Do–Sun

doi:10.12997/jla.2015.4.2.149

Cited by 1 publication

(1 citation statement)

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“…After post-dilatation with a 4.5 mm non-compliant balloon, and kissing balloon post-dilatation of the LMS bifurcation, the end result within the coronaries was angiographically satisfactory ( Figure 1D ). Once the LMS bifurcation stenting was complete, the avulsed unravelled stent that protruded into the aorta was forced against the superior aortic sinus wall using the tip of the guide catheter which was fixed in the coronary by an inflated semi-compliant balloon (a technique which has previously been described in the literature for protruding stent apparatus 10 ). The procedure was optimized by Intravascular Ultrasound (IVUS) with a 5.0 mm non-compliant balloon to the LMS.…”

Section: Case Presentationmentioning

confidence: 99%

Case series of iatrogenic coronary stent avulsion: a rare complication with varied management strategies

Protty

O’Neill

Kinnaird

et al. 2021

European Heart Journal - Case Reports

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Background Coronary stent avulsion is a rare, infrequently reported complication of percutaneous coronary intervention (PCI) with no consensus on management options. Case summary This case series presents three descriptions of iatrogenic coronary stent avulsions, and three different bailout management strategies. All patients presented with acute coronary syndrome and required PCI. In the first case, a freshly implanted stent was entrapped in a coronary guidewire and avulsed upon withdrawal of the wire into the aortic sinus. In the second case, a staged procedure to implant a new stent was complicated by stent dislodgement and entanglement with a recently implanted stent leading to avulsion of both stents into the aortic sinus and resultant dissection to the coronary arteries. In the third case, following a successful stent implantation, the tip of the coronary guidewire was bound to the proximal edge of the stent resulting in avulsion of the newly implanted stent into the ascending aorta upon retraction of the wire at the end of the procedure. The first two patients were managed percutaneously, and the third surgically. All patients have had acceptable technical and clinical outcomes. Discussion In the absence of a consensus on best bailout management strategy, we discuss the mechanisms of and the potential management options for this rare, but serious, complication.

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Section: Case Presentationmentioning

confidence: 99%