Stent loss in aorta or peripheral circulation
Coronary stent loss complications
Stent loss may occur in the cerebral/carotid arteries, above the left subclavian artery or above the femoral sheath and underlines why the site of stent dislodgement is therefore very important. Complications such as guidewire remnants can lead to an acute ischaemic events due to thromboembolic occlusion or perforation. Conservative management or the assistance of a neuroradiologist may therefore be required. This section explores the different parameters that will help better manage this complication …
Table of content
Introduction
Stent loss may occur in the cerebral/carotid arteries, above or below the common femoral artery. The site of stent dislodgement is therefore important. Retrieval techniques in case of the femoral approach or the snaring technique are described.
Management overview
The lost device is now in the iliac artery, but how do you successfully retrieve it without resorting to surgical vascular cut-down?
- Femoral approach - above the common femoral artery: Learn about the femoral approach here in the event that the stent is dislodged above the common femoral artery.
- Femoral approach - below the common femoral artery: Learn about the femoral approach here in the event that the stent is dislodged below the common femoral artery.
Key messages:
- Ensure adequate anticoagulation
- Stent loss below the femoral artery is not considered as a clinical issue
- Stent loss by radial access: consider femoral approach for retrieval
- Stent loss by femoral access: consider contralateral femoral approach for retrieval
- Stent loss in cerebral circulation should always be retrieved, consider assistance by a neuroradiologist
Additional links
References - Stent loss complications
Case library
Consult the Case study by Patrick Calvert: I wish I hadn’t started this
Update November 2018 - New clinical cases
Consult this Case study by S.Basavarajaiah et al.: Stent lost and retrieved
Consult this Case study by by G. Arutiunian: Check it before you wreck it
Consult this Case study N. B. Fitzpatrick et al.: Coughing concomitant with stent deployment
