Stent dislodgement in the distal left main coronary artery and its successful management with balloon crushing technique
Introduction. Stent entrapment and dislodgment in the coronary arteries is a rare but potentially fatal complication of percutaneous coronary intervention. Different retrival techniques of dislodged stents have previously been reported with high success rate but all of them are timeconsu...
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| Main Author: | |
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| Format: | Article |
| Language: | English |
| Published: |
Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade
2015-01-01
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| Series: | Vojnosanitetski Pregled |
| Subjects: | |
| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2015/0042-84501500008S.pdf |
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| Summary: | Introduction. Stent entrapment and dislodgment in the coronary arteries is a
rare but potentially fatal complication of percutaneous coronary
intervention. Different retrival techniques of dislodged stents have
previously been reported with high success rate but all of them are
timeconsuming, so as not quite useful in hemodinamically unstable patient.
Case report. A 59-year old female patient with acute ST-elevation myocardial
infaction of anterior wall was admitted for primary percutanous coronary
intervention. Unexpectedly, during intervention stent entrapment and
dislodgement in the distal left main coronary artery occured followed by
occlusive coronary dissection and compromisation of the coronary flow in the
left descending coronary artery with a rapid hemodinamic deterioration. In
order to reestablish coronary flow as soon as possible, the dislodged
unexpanded stent was crushed against the wall with a balloon in the distal
left main. It immediately restored coronary flow in the left descending
coronary artery and rapidly improved the patients hemodinamics. Intervention
was successfuly completed with totally four stents implanted in the left
main, the osteoproxymal circumflex coronary artery and the osteo-proxymedial
left descending coronary artery. Later postinterventional hospital course as
well as the clinical and angiographic six month follow-up was uneventful.
Conclusion. This case shows that percutaneous baloon crushing technique can
be a safe and effective first option in management of dislodged and
unexpanded stent in the left main coronary artery, particularly for a
hemodynamically unstable patient. |
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| ISSN: | 0042-8450 |