eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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SCImago Journal & Country Rank
3/2015
vol. 11
 
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Case report

Undeployed and uncrushed coronary stent in the proximal region of the normal left anterior descending artery revealed four years after intervention

Ibrahim Kocayigit
,
Yusuf Can
,
Sabiye Yılmaz
,
Harun Kılıç

Postep Kardiol Inter 2015; 11, 3 (41): 256–257
Online publish date: 2015/09/28
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- undeployed.pdf  [0.17 MB]
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Intracoronary undeployed stent embolization is a rare and devastating complication of percutaneous coronary intervention (PCI). This unexpected complication can lead to coronary thrombosis, myocardial infarction, cardiogenic shock and even death. Stent embolization or misplacement has been reported in 0.3% to 1.2% of PCIs in the literature [1, 2]. Several urgent retrieval and surgical management methods have been described, but short- and long-term outcomes remain unknown. We describe an unusual case of an undeployed coronary stent in a normal left anterior descending artery (LAD) revealed 4 years after coronary intervention. A 62-year-old man was admitted to our hospital with chest pain. He had a history of coronary artery disease with previous percutaneous coronary angioplasty and stenting in both the right coronary artery (RCA) and the left circumflex artery (LCX) 4 years ago. He had been treated with dual antiplatelet therapy for 1 month after coronary intervention, then clopidogrel therapy was withheld and acetylsalicylic acid therapy continued. After the first evaluation, left heart catheterization was planned. Coronary angiography showed an undeployed and uncrushed coronary stent in the proximal region of the normal LAD, and non-critical lesions in the RCA and LCX (Figure 1 A, B). No further intervention was performed because distal coronary flow was normal and there was no critical stenosis. Myocardial perfusion scintigraphy (MPS) was planned to evaluate ischemia. Myocardial perfusion scintigraphy showed no ischemia (Figure 1 C). Several retrieval methods and crushing techniques have been described in the literature [1, 3]. Conservative treatment of the embolized stent after unsuccessful crushing has also been reported previously, but this is the first report of an undeployed and uncrushed embolized coronary stent in the proximal region of a normal LAD [4].

Conflict of interest

The authors declare no conflict of interest.

References

1. Eggebrecht H, Haude M, et al. Nonsurgical retrieval of embolized coronary stents. Catheter Cardiovasc Interv 2000; 51: 432-40.
2. Kozman H, Wiseman AH, Cook JR. Long-term outcome following coronary stent embolization or misdeployment. Am J Cardiol 2001; 88: 630-4.
3. Wani SP, Rha SW, Park JY. Entrapment of a drug-eluting stent in left anterior descending artery and left main artery leading to a life-threatening complication. J Invasive Cardiol 2010; 22: E90-2.
4. Saleh L, Movahed MR. Successful conservative treatment of an undeployed embolized intracoronary stent with dual antiplatelet and warfarin therapy. Exp Clin Cardiol 2010; 15: e70-2.
Copyright: © 2015 Termedia Sp. z o. o. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (http://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
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