Coronary stent migration into the aorta during implantation in the orifice of the right coronary artery and its elimination: Review with a clinical case

Abstract

The purpose of this study was to analyse a vivid clinical case of problematic stent extraction that migrated during coronary stenting. Materials and methods. The following clinical methods of research were used: general laboratory and instrumental, which were applied in interventional cardiology. Results and discussion. A patient born in 1950 with pronounced symptoms of cardiac pathology was admitted to the cardiology department. The diagnosis of coronary heart disease in the form of class III of angina pectoris was established. Coronary angiography was recommended to the patient, where 3 vascular lesions of the coronary arteries were detected, coronary artery bypass grafting was recommended, which the patient flatly refused. Coronary stenting was performed 2 days later, but a complication occurred during the intervention – stent dislocation and migration during implantation into the mouth of the right coronary artery, which occurred during endovascular interventions for myocardial revascularisation in coronary heart disease. The causes of such complications have been identified, and the endovascular methods used in their treatment have been described. Several attempts have been made to extract the migrated stent, but the first of them were unsuccessful. Only after 5 attempts to remove the migrated stent using the ONE SNARE endovascular trap was success achieved. Conclusions. The article provides a comprehensive analysis of the problem of stent migration in various vascular systems and organs, emphasizing the seriousness and complexity of this phenomenon. It demonstrates the importance of timely diagnosis and discusses treatment approaches that can reduce the risk of complications and improve patient outcomes.