Complications during acute coronary intervention are rare and life-threatening. We present a case of a patient with acute coronary syndrome admitted for percutaneous coronary intervention to the left anterior descending artery. The straightforward procedure was challenged by multiple complications of coronary artery perforation, cardiac tamponade, stent loss, and ventricular fibrillation. The management was complicated by covered stent embolization into the left circumflex artery without a wire inside. We were able to retrieve the lost covered stent by re-accessing the lumen with a coronary guidewire followed by advancing a balloon distal to the stent and extraction of the whole system outside. The case illustrates the possibility of facing multiple complications in one procedure including the loss of covered stent and how to prevent and manage this serious complication.
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