Srpski arhiv za celokupno lekarstvo 2011 Volume 139, Issue 9-10, Pages: 669-672
https://doi.org/10.2298/SARH1110669S
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Successful retrieval of an unexpanded coronary stent from the left main coronary artery during primary percutaneous coronary intervention
Šalinger-Martinović Sonja (Klinika za kardiovaskularne bolesti, Klinički centar, Niš)
Stojković Siniša (Klinika za kardiologiju, Klinički centar Srbije, Beograd)
Pavlović Milan (Klinika za kardiovaskularne bolesti, Klinički centar, Niš)
Perišić Zoran (Klinika za kardiovaskularne bolesti, Klinički centar, Niš)
Obradović Slobodan (Klinika za kardiologiju, Vojnomedicinska akademija, Beograd)
Apostolović Svetlana (Klinika za kardiovaskularne bolesti, Klinički centar, Niš)
Živković Milan (Klinika za kardiovaskularne bolesti, Klinički centar, Niš)
Božinović Nenad (Klinika za kardiovaskularne bolesti, Klinički centar, Niš)
Introduction. Dislodgement and embolization of the new generation of coronary
stents before their deployment are rare but could constitute a very serious
complication. Case Outline. We report a case of a stent dislodgement into the
left main coronary artery during the primary coronary intervention of infarct
related left circumflex artery in a patient with acute myocardial infarction.
The dislodged and unexpanded bare-metal stent FlexMaster 3.0x19 mm (Abbot
Vascular) was stranded and bended in the left main coronary artery (LMCA),
probably by the tip of the guiding catheter, but stayed over the guidewire.
It was successfully retrieved using a low-profile Ryujin 1.25x15 balloon
catheter (Terumo) that was passed through the stent, inflated and then pulled
back into the guiding catheter. After that, the whole system was withdrawn
through the 6 F arterial sheath via the transfemoral approach. After repeated
cannulation via the 6F arterial sheath, additional BMW and ATW guidewires
were introduced into the posterolateral and obtuse marginal branches and a
bare-metal stent Driver (Medtronic Cardiovascular Inc) 3.0x18 mm was
implanted in the target lesion. Conclusion. Stent dislodgement is a rare but
potentially life-threatening complication of the percutaneous coronary
intervention. This incident occurring in the LMCA in particular during an
acute myocardial infarction requires to be urgently resolved. The avoidance
of rough manipulation with the guiding catheter and delivery system may help
in preventing this kind of complications.
Keywords: STEMI, primary angioplasty, bare metal stent, dislodgement
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