Coronary stent dislodgement is a relatively infrequent iatrogenic complication associated with percutaneous coronary intervention (PCI). It can result in severe outcomes, including vascular embolism, coronary rupture, malignant arrhythmia, and even death. We reported a patient who previously underwent stent implantation in the left anterior descending artery (LAD) and required a second-stage surgery. During the insertion of a new stent into the left circumflex artery (LCX), the guidewire passed through the mesh of the original stent. This caused the new stent to pull and deform the original stent during advancement. Consequently, the new stent dislodged, and the two stents intertwined and floated in the aorta. Eventually, the two stents were successfully removed using a stent snare, and a new stent was reimplanted in the LAD, thereby avoiding the risk of the dislodged stent falling into other arteries and causing embolism. In our case, the characteristic of the original stent protruding into the left main coronary artery (LM) and the surgeon’s failure to promptly confirm the position of the guidewire were the main causes of this incident, which provide valuable experience for future interventional surgeries. When the original stent located at the bifurcation of the blood vessel is passed through, preoperative assessment of the spatial relationship between the blood vessels, careful confirmation of the position of the guidewire, and timely analysis of whether stent dislodgement, traction, etc. occurs when advancement is impeded are critical to procedural success.
Liao et al. (Wed,) studied this question.