Acute Stent Loss and Its Retrieval of a Long, Tapering Morph Stent in a Tortuous, Calcified Lesion

Sinha, Santosh Kumar; Mahrotra, Anupam; Abhishekh, Nishant Kumar; Razi, Mohammad; Aggarwal, Priyanka; Tripathi, Sunil Kumar; Rekwaal, Lokendra; Singh, Anupam

doi:10.14740/cr627w

Cited by 3 publications

(3 citation statements)

References 8 publications

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“…The long-tapered BioMime Morph SES system comes with a tapered balloon and is designed to undergo “morphology-mediated” expansion and therefore prevents artery dissection or over-inflation at the distal end of the lesion. In fact, few case studies have reported that using long-tapered stent offers the advantage of favorable adaptation to vessel tapering, vessel size, and good apposition in patients with long-tapered coronary lesions along with good coronary flow [14, 15].…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes of Novel Long-Tapered Sirolimus-Eluting Coronary Stent System in Real-World Patients With Long Diffused De Novo Coronary Lesions

et al. 2018

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BackgroundWhen coronary lesions involve segments > 48 mm, the only treatment possibility is stent overlapping which is associated with higher neointimal proliferation that lead to more restenosis. Furthermore, tapering of coronary arteries is a major challenge observed with long diffuse coronary lesions. This study attempted to assess the safety and performance of world’s first commercialised long-tapered (60 mm) sirolimus-eluting coronary stent (SES) system for the treatment of long diffused de novo coronary lesions in real world scenario.MethodsThis was a retrospective, non-randomised, multicentre study which included 362 consecutive patients implanted with long-tapered BioMime™ Morph SES system for the treatment of long diffused de novo coronary lesions. Safety endpoint was major adverse cardiac events (MACE), which was defined as composite of cardiac death, myocardial infarction (MI) and ischemic-driven target lesion revascularization (ID-TLR), at 12-month follow-up.ResultsOut of 362 patients included, 170 (47.0%) were diabetic and 159 (43.9%) were hypertensive. The mean age of all patients was 61.09 ± 9.04 years. A total of 625 lesions were identified; out of which 402 lesions were intervened successfully using BioMime Morph. The cumulative incidence of MACE was 7 (2.0%) at 12-month follow-up which included four (1.1%) cardiac deaths, one (0.3%) case of MI and two (0.6%) ID-TLR. Acute stent thrombosis was reported in one (0.3%) patient.ConclusionsThe present study confirms the safety and performance of BioMime Morph, and hence, can be considered as a treatment of choice for long diffused tapered de novo coronary lesions in routine clinical practice.

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Section: Discussionmentioning

confidence: 99%

Clinical Outcomes of Novel Long-Tapered Sirolimus-Eluting Coronary Stent System in Real-World Patients With Long Diffused De Novo Coronary Lesions

et al. 2018

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“…1 Retrieval or exclusion can be done either surgically or through percutaneous transcatheter techniques like a passage of a small distal balloon, the double-wire braiding technique or "knot" technique, the use of snaring device over a second wire, the stent-crush exclusion technique, extracting it by snaring from contralateral arterial access, and lastly deploying and crushing it in another similar sized vascular bed. [2][3][4][5][6][7][8] Newer balloonmounted stents with better radio-opacity made this complication rare. The prevalence of stent dislodgment is highest, with left main and LAD stenting, followed by LCX and RCA.…”

Section: Discussionmentioning

confidence: 99%

Dislodged Deployed DES (Drug-eluting Stent) Dismantles a Doyen—Case report

Mondal,

Iliyas,

Sasidharan

2024

Indian Journal of Clinical Cardiology

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Background: Left main stenting with significant stenosis in symptomatic patients is an alternative strategy of revascularization in cases of low syntax scores with high surgical risk. Stent dislodgement is a rare complication, even rarer when it is already deployed. Percutaneous retrieval of a stent when it is fully deployed, is usually not recommended as it predisposes to a higher rate of dreaded vascular complications. Case presentation: A case of dislodgment of a fully deployed stent in the left main is reported here, which was successfully deployed in another vascular bed without requiring invasive surgical retrieval. Conclusions: Meticulous efforts for stent sizing, landing zone, and balloon expansion are of utmost importance, especially in cases of left main stenting where the risk of systemic embolization is higher. Monitoring stent position during balloon deflation, withdrawal, or manipulation of guide catheters is critical for promptly detecting stent dislodgement. Deploying a fully dilated dislodged stent in a favorable vascular bed is an important bail-out strategy.

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“…Data about the interventional performance and clinical results of this new device are limited to some case reports [21,22] and a recent study by Valero et al describing the procedural outcomes of 50 CAD patients treated with the 60 mm BM [23]. These authors reported a 92% rate of successful BM deployment, with 18% of GuideLiner™ use to deploy the stent.…”

Section: Discussionmentioning

confidence: 99%

Real-World Experience With a Tapered Biodegradable Polymer-Coated Sirolimus-Eluting Stent in Patients With Long Coronary Artery Stenoses

et al. 2020

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Background: Treatment of long coronary stenoses (LCS) with long tapered drug-eluting stents (LT-DES) would offer clinical and economic benefits. However, the feasibility of an interventional strategy based upon the systematic LCS treatment with an LT-DES has not been evaluated so far. Methods: We performed a multicenter prospective study including consecutive patients with: 1) An LCS > 25 mm at coronary angiography; 2) An attempt to fix the LCS with a single BioMime Morph™ stent, a novel LT-DES available from 30 to 60 mm long. The primary efficacy endpoint was procedural success. The secondary safety endpoints were post-procedural TIMI3 flow, stent detachment during delivery, acute stent thrombosis and in-hospital mortality. Results: From February 2017 to March 2018, we recorded 272 patients with an LCS and an attempt to deploy an LT-DES during percutaneous coronary intervention (PCI) (69.3 ± 11.4 years, 75.7% males, 25.7% diabetic and 43.8% with acute coronary syndromes, mean LCS length 48.8 ± 9.5 mm). LT-DES deployment was successful in 262 patients (96.3%), and failure occurred without stent detachment or other complications. Final TIMI3 flow was present in 270 (99.3%) patients. In-hospital death occurred in five patients (1.8%), with no case of acute stent thrombosis, recurrent myocardial infarction or repeated revascularization. Conclusion: In this real-world study, a strategy of fixing LCS with a single LT-DES was feasible and safe, with a high rate of procedural success and a low rate of in-hospital complications. More extensive randomized studies are warranted to assess the potential clinical and economic benefits of LT-DES.

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Acute Stent Loss and Its Retrieval of a Long, Tapering Morph Stent in a Tortuous, Calcified Lesion

Cited by 3 publications

References 8 publications

Clinical Outcomes of Novel Long-Tapered Sirolimus-Eluting Coronary Stent System in Real-World Patients With Long Diffused De Novo Coronary Lesions

Clinical Outcomes of Novel Long-Tapered Sirolimus-Eluting Coronary Stent System in Real-World Patients With Long Diffused De Novo Coronary Lesions

Dislodged Deployed DES (Drug-eluting Stent) Dismantles a Doyen—Case report

Real-World Experience With a Tapered Biodegradable Polymer-Coated Sirolimus-Eluting Stent in Patients With Long Coronary Artery Stenoses

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