A Novel Technique for Retrieval of a Drug-Eluting Stent After Catheter Break and Stent Loss

Abstract

Break of a stent delivery catheter and subsequent stent loss (SL) has been a rare event in the drug-eluting stent (DES) era. We here report a case of successful retrieval of a stent after a break if the delivery catheter and SL from a balloon catheter at a culprit lesion. We finally resolved this situation using a simple balloon technique for both the broken stent catheter inside of the guide catheter and the unexpanded stent in the culprit lesion. Thus balloons are an important weapon in our armamentarium in the cardiac catheterization laboratory for urgent retrieval of a lost stent. Their apt use definitely allowed our patient to avoid undergoing emergency cardiovascular thoracic surgery.

Case Report: STENT DISLODGEDMENT

“…On the technical factor, too excessive maneuvering on the stent without sufficient predilatation may cause deformation and distortion of the stent itself. The withdrawal of the stent that is not fixed properly on the situation increases the risk of stent loose (Wani et al 2010). If the stent is loose and broken and no immediate withdrawal of the coronary arteries is done by percutaneous device, it will be able to cause coronary thrombosis and continue until the occurrence of myocardial infarction.…”

“…This examination provides information about the distribution of calcification and plaque. If there are doubts about the failure to penetrate the lesion that may add to the complications, then it takes a more mature preparation before taking action especially if IVUS inspection cannot be performed (Wani et al 2010). Today, IVUS imaging plays a very important in view of the position damaged stent.…”

Percutaneous retrieval of an embolized catheter tip with the balloon dilatation technique

“…Patients who experience embolization of foreign bodies in the vasculature have a considerably increased risk for adverse events, depending on the site of embolization. Different surgical and non-surgical methods to handle embolic complications have been proposed for different clinic situations (4)(5)(6)(7)(8)(9). Our study appears to offer a safe and relatively simple method of balloon dilatation inside the lumen of the embolized fragment, to be used when the foreign body is too distal to retrieve with conventional snare systems (10).…”

Approaches for dislodged stent retrieval during transradial percutaneous coronary interventions

“…Stent dislodgement rate was reported to be highest in the left main artery and the left anterior descending artery, while the left circumflex artery and the right coronary arteries showed a comparable dislodgement rate . Risk factors for dislodgement of stent include severe coronary angulations, coronary tortuousity, diffuse long lesions, and calcified coronary arteries . Stent dislodgement is frequently related to technical issues such as direct stenting or forceful maneuvering of the stent without adequate pre‐dilation or debulking process.…”