Retrieving a Stent: Navigating Deep Complications

Objective: The authors describe a case of an infrequent complication of percutaneous coronary intervention in a patient with acute ST-segment elevation myocardial infarction and discuss considerations for its prevention, recognition, and treatment.

Key Steps: Diagnostic coronary angiography confirmed an acute total occlusion of the proximal right coronary artery. Angioplasty and stenting were performed without complications. A second stent was advanced to treat a distal lesion. During the advancement, stent dislodgement from the guidewire, with entrapment in the struts of the previously placed stent and migration to the proximal aorta, was identified. A multisnare device was used for stent retrieval, with embolization to the right femoral artery during the process.

Potential Pitfalls: Operators should be aware of this potential complication and its management techniques. Stent dislodgement and migration should be rapidly identified and addressed because these adverse events can lead to embolization, thrombosis, and vascular damage.