At this point, we inserted a second wire next to the stent (Figure 5).
A 2.5 mm balloon was placed over the new wire and positioned next to the stent-balloon system. The guiding catheter advanced to capture the stent.
The balloon was inflated to splint the stent against the guiding catheter and the whole system was taken out including the guiding catheter (Figure 6).
The balloon had to be deflated at the end of radial sheath for retrieving the whole system. Everything came out, except the stent! (Figure 7.1 and Figure 7.2)
We completed the procedure with a new stent (3.5 x 33 mm DES), which was successfully delivered and deployed with the help of a Guideliner. We then inserted 6F short sheath into the ulnar artery (Figure 9.1, 9.2 and 9.3).
Using a micro-snare, the stent was successfully retrieved with out any complications.
Final angiographic result
Final ulnar angiography showed no dissection and the flow was good (Figure 10.1 and 10.2).
Conclusion
- Patient was discharged 24-hours later with no complications.
30 Jan 2019
Case study: stent lost and retrieved
Coronary stent loss complications
Consult this clinical case a 72-year-old man with crescendo angina by S. Basavarajaiah and I. Mohammed on how to capture a stent loss to RCA into the ulnar artery.
Author
Interventional cardiologist / Cardiologist
Birmingham, United Kingdom
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Clinical presentation
Figure 2.1
Figure 2.1
Procedure
Lesion was crossed with Fielder XTA wire and Corsair, which was then exchanged to a supportive wire (Sion extra-support) (Figure 2.2).
Figure 2.2
Figure 2.2
Predilated sequentially with 2.0, 2.5 and 3.0 mm NC balloons.
3.0 x 38 mm DES was delivered to distal RCA successfully and deployed (Figure 3)
Figure 3
Figure 3
While delivering the 2nd stent (3.5 x 33 mm) it got stuck and distorted as it was coming out of the guiding catheter (Figure 4).
Figure 4
Figure 4
In addition, an attempt to retrieve the stent was resulting in stent being stripped of the balloon. So, we stopped.
At this point, we inserted a second wire next to the stent (Figure 5).
Figure 5
Figure 5
A 2.5 mm balloon was placed over the new wire and positioned next to the stent-balloon system. The guiding catheter advanced to capture the stent.
The balloon was inflated to splint the stent against the guiding catheter and the whole system was taken out including the guiding catheter (Figure 6).
Figure 6
Figure 6
The balloon had to be deflated at the end of radial sheath for retrieving the whole system. Everything came out, except the stent! (Figure 7.1 and Figure 7.2)
Figure 7.1
Figure 7.1
Figure 7.2
Figure 7.2
We completed the procedure with a new stent (3.5 x 33 mm DES), which was successfully delivered and deployed with the help of a Guideliner. We then inserted 6F short sheath into the ulnar artery (Figure 9.1, 9.2 and 9.3).
Figure 8.1
Figure 8.1
Figure 8.2
Figure 8.2
Figure 9.1
Figure 9.1
Figure 9.2
Figure 9.2
Figure 9.3
Figure 9.3
Using a micro-snare, the stent was successfully retrieved with out any complications.
Final angiographic result
Final ulnar angiography showed no dissection and the flow was good (Figure 10.1 and 10.2).
Figure 10.1
Figure 10.1
Figure 10.2
Figure 10.2
Conclusion
Key messages
For further reading, please consult Stent loss in aorta or peripheral circulation
Disclaimer
This case report does not reflect the opinion of PCR or PCRonline, nor does it engage their responsibility.
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