Coronary lost scaffold: lost on the wire
Coronary scaffold loss complications
This section explains how to manage scaffold loss complications when the loss occurs on the wire. Discover the different steps to use when the scaffold loss is in the coronary artery with the guidewire in situ and learn about the various techniques such as the use of imaging enhancement technologies and advanced balloon catheter techniques.
Table of content
Introduction
The first challenge when facing a lost coronary scaffold on the wire is dealing with poor or non-existent radiopaque markers. Begin with image enhancement technologies, slowly advance the balloon catheter on the wire and, depending on the success or failure of identifying the lost wire, consider different types of approaches to retrieval or implantation.
Management overview
- How to identify the radiopacity? Scaffolds are radiolucent, which requires them to have small metal markers embedded in each end so that the physicians can identify the location of the scaffold under fluoroscopy.
- Advance balloon catheter on wire: Consult this short demonstration from the Städtische Kliniken Neuss, Lukaskrankenhaus, Neuss - Germany to learn how to advance a balloon catheter on the wire and track it by image enhancement technology until the scaffold markers are identified.
- Crush technique: The crush technique offers a valid response in the attempt to retrieve a lost scaffold. Learn how to master this technique?
- Total stent loss with guidewire in situ: Stent loss and embolisation although infrequent has not been eliminated entirely. This section describes what to do when total stent loss occurs on the guidewire within the coronary artery.
Key messages:
- Always ensure adequate anticoagulation
- Maintain guidewire position
- Identify scaffold markers by imaging technology: fluoroscopy and enhancement technique
Additional links
References - Lost scaffold complications
Case library
Consult the 1st Case study by C. Y. Chin and S. T. Lim: dislodged bioresorbable scaffold
Disclaimer
This case report does not reflect the opinion of PCR or PCRonline, nor does it engage their responsibility.
