Extraction of Protruding Ostial Stents to Enable Percutaneous Coronary Interventions

BACKGROUND: Protruding coronary ostial stents can be prohibitive for repeat percutaneous coronary interventions (PCI). METHODS: We retrospectively included 6 consecutive patients who underwent the EXPOSE (extraction of protruding ostial stents with En Snare) technique to previous ostial stents to facilitate subsequent PCI. The indication in all cases was revascularization of the target vessel with failed guide intubation of the stented lumen. The protruding stents had been implanted 5 days to 9 years before extraction. The procedure included a 7-F × 45-cm transfemoral sheath, 7-F guide catheter, and 12- to 20-mm En Snare device. RESULTS: Procedural success was achieved in all patients, and complete stent extraction was achieved in 1 patient. All patients underwent successful PCI; 1 case of acute vessel closure immediately postextraction was rescued promptly with PCI. CONCLUSIONS: Snare extraction of previously implanted, protruding ostial stents is feasible to enable PCI after failure of guide intubation.