Two Stents' Dislodgement in the Left Main Coronary Artery: a Case Report

Overview

Journal J Med Case Rep

Publisher Biomed Central

Specialty General Medicine

Date 2024 Mar 18

PMID 38494477

Authors

Salim Arous

Hatim Zahidi

Mohamed El Ghali Benouna

Rachida Habbal

Affiliations

Soon will be listed here.

Abstract

Background: Stent dislodgement is a life-threatening complication that can result in coronary artery embolization, stent thrombosis, acute myocardial infarction, and even death. Severely angulated, heavily calcified, and previously stented coronary arteries are associated risk factors. With the development of different lesion preparation techniques and the drug eluting stent era, the reported incidence of stent dislodgement has decreased to < 1% in the last few years.

Case Presentation: We report a case of a 64-year-old Moroccan man complicated during percutaneous intervention in the left main artery by the loss of two stents. This complication was successfully managed by passing the stent's balloon into the stent and then fully expanding it. In our case, the device's characteristics were involved and could play a role in such complications, but it is still not well understood.

Conclusions: The main treatment option is stent retrieval with different available techniques. If retrieval of the stent is impossible, crushing it against the blood vessel wall could be considered.

Citing Articles

Stent Crumpling as a Complication of Percutaneous Coronary Intervention, a Case Report and Literature Review.

Mehrpooya M, Vahidi H, Taheri M, Ebrahimi P Clin Case Rep. 2025; 13(2):e70212.

PMID: 39935653 PMC: 11810625. DOI: 10.1002/ccr3.70212.

References

Wongpraparut N, Yalamachili V, Leesar M . Novel implication of combined stent crushing and intravascular ultrasound for dislodged stents. J Invasive Cardiol. 2004; 16(8):445-6. View

Colkesen A, Baltali M, Acil T, Tekin G, Tekin A, Erol T . Coronary and systemic stent embolization during percutaneous coronary interventions: a single center experience. Int Heart J. 2007; 48(2):129-36. DOI: 10.1536/ihj.48.129. View

Kostantinis S, Karacsonyi J, Simsek B, Brilakis E . Complications of Stent Loss During Treatment of a Heavily Calcified and Tortuous Chronic Total Occlusion. Cardiovasc Revasc Med. 2021; 40S:293-297. DOI: 10.1016/j.carrev.2021.11.013. View

Iturbe J, Abdel-Karim A, Papayannis A, Mahmood A, Rangan B, Banerjee S . Frequency, treatment, and consequences of device loss and entrapment in contemporary percutaneous coronary interventions. J Invasive Cardiol. 2012; 24(5):215-21. View

Brilakis E, Best P, Elesber A, Barsness G, Lennon R, Holmes Jr D . Incidence, retrieval methods, and outcomes of stent loss during percutaneous coronary intervention: a large single-center experience. Catheter Cardiovasc Interv. 2005; 66(3):333-40. DOI: 10.1002/ccd.20449. View

Holmes Jr , Garratt , Popma . Stent Complications. J Invasive Cardiol. 2000; 10(7):385-395. View

Egbuche O, Mezue K, Nwokike S, Abe T, Olanipekun T, Onuorah I . Left main stenting with stent dislodgement and entrapment in the common femoral artery: a successful transcatheter stent retrieval. Am J Cardiovasc Dis. 2021; 11(3):421-428. PMC: 8303031. View

Rigatelli G, Zuin M, Gianese F, Adami D, DellAvvocata F, Barison S . Ultrathin Biodegradable-Polymer Orsiro Drug-Eluting Stent Performance in Real Practice Challenging Settings. Cardiovasc Revasc Med. 2020; 30:12-17. DOI: 10.1016/j.carrev.2020.09.027. View

Laarman G, Muthusamy T, Swart H, Westendorp I, Kiemeneij F, Slagboom T . Direct coronary stent implantation: safety, feasibility, and predictors of success of the strategy of direct coronary stent implantation. Catheter Cardiovasc Interv. 2001; 52(4):443-8. DOI: 10.1002/ccd.1099. View

10.

Cantor W, Lazzam C, Cohen E, Bowman K, Dolman S, Mackie K . Failed coronary stent deployment. Am Heart J. 1998; 136(6):1088-95. DOI: 10.1016/s0002-8703(98)70168-1. View

11.

Bolte J, Neumann U, Pfafferott C, Vogt A, Engel H, Mehmel H . Incidence, management, and outcome of stent loss during intracoronary stenting. Am J Cardiol. 2001; 88(5):565-7. DOI: 10.1016/s0002-9149(01)01742-8. View

12.

Rigatelli G, Zuin M, Vassilev D, DellAvvocata F, Giordan M, Conte L . Risk of Dislodgement of Ultrathin Drug Eluting Stents Versus Thick Drug Eluting Stents. Am J Cardiol. 2020; 125(11):1619-1623. DOI: 10.1016/j.amjcard.2020.03.005. View

13.

Meisel S, Dileo J, Rajakaruna M, Pace B, Frankel R, Shani J . A technique to retrieve stents dislodged in the coronary artery followed by fixation in the iliac artery by means of balloon angioplasty and peripheral stent deployment. Catheter Cardiovasc Interv. 2000; 49(1):77-81. DOI: 10.1002/(sici)1522-726x(200001)49:1<77::aid-ccd17>3.0.co;2-y. View

14.

Ijsselmuiden A, Tangelder G, Cotton J, Vaijifdar B, Kiemeneij F, Slagboom T . Direct coronary stenting compared with stenting after predilatation is feasible, safe, and more cost-effective in selected patients: evidence to date indicating similar late outcomes. Int J Cardiovasc Intervent. 2003; 5(3):143-50. DOI: 10.1080/14628840310017807. View

15.

Eggebrecht H, Haude M, von Birgelen C, Oldenburg O, Baumgart D, Herrmann J . Nonsurgical retrieval of embolized coronary stents. Catheter Cardiovasc Interv. 2000; 51(4):432-40. DOI: 10.1002/1522-726x(200012)51:4<432::aid-ccd12>3.0.co;2-1. View

16.

Seo K, Yang H, Lim H, Yoon M . Stent dislodgement force of drug-eluting coronary stents: a bench test. Cardiovasc Diagn Ther. 2022; 12(3):370-377. PMC: 9253166. DOI: 10.21037/cdt-22-49. View

17.

Alomar M, Michael T, Patel V, Altomare C, Rangan B, Cipher D . Stent loss and retrieval during percutaneous coronary interventions: a systematic review and meta-analysis. J Invasive Cardiol. 2013; 25(12):637-41. View

18.

Kirk M, Herzog W . Deployment of a previously embolized, unexpanded, and disarticulated Palmaz-Schatz stent. Cathet Cardiovasc Diagn. 1997; 42(3):331-4. DOI: 10.1002/(sici)1097-0304(199711)42:3<331::aid-ccd25>3.0.co;2-n. View

19.

Lohavanichbutr K, WEBB J, Carere R, Solankhi N, Jarochowski M, Dyachkova Y . Mechanisms, management, and outcome of failure of delivery of coronary stents. Am J Cardiol. 1999; 83(5):779-81, A9. DOI: 10.1016/s0002-9149(98)00990-4. View