Longitudinal Stent Deformation in Undeployed Stents: A Case Series

Figure 1. The angiographic images show LSD in an undeployed stent and its management. The AP cranial view shows: A) tubular 90% stenosis in the LAD (arrow), B) an in situ semi-compliant balloon for pre-dilation (arrows), C) failure to negotiate a TAXUS Liberté Stent (arrows) across the lesion, and D) the lodging of the deformed stent (the white block arrow) at the tip of the first GC (disengaged from the LM) on a Zinger support guidewire still across the lesion (asterisk). The LCA was engaged with a second GC (the line arrow), and a second coronary wire (arrowhead) was used to cross the lesion in the occluded LAD. E) Stenting with a 3 m × 28 mm drug-eluting stent through the second GC (arrowhead) while the first guide with the deformed stent on the guidewire was parked in the aorta (block arrow). F) The final angiogram shows good results. G) The LAO caudal view shows a longitudinally deformed TAXUS Liberté Stent lodged at the GC tip (white block arrow). It is far from the proximal balloon marker within the guide (black line arrow within the 'GC'), but it is still crimped on the balloon at the distal end (black line arrow). H) The AP view shows that the whole system is retrieved through the…

Figure 2. The angiographic images show LSD in an undeployed stent and its retrieval. A) The RAO/caudal view of the LAD shows eccentric and calcified stenosis (90%) (circle). B) The AP cranial view here was obtained after the pre-dilation of the lesion with an in situ semi-compliant balloon (black arrows). C) Following the failure to cross the lesion, the deformed Firehawk Stent (white block arrow), which was lodged at the tip of the first GC and was disengaged from the LM, was pulled back with the first coronary guidewire in situ (white line arrow). The LM was engaged with a second GC (black block arrow), and a second coronary guidewire (black line arrow) was used to cross the lesion in the LAD. D) After the removal of the first wire, stenting was accomplished with a 3 mm × 22 mm drug-eluting stent (circle) through the second GC. The first GC, along with the deformed stent, was parked in the descending aorta (white arrow). E) The final angiogram in the AP cranial view shows no residual stenosis. F) The deformed Firehawk Stent (white arrow) on the balloon (black arrows) with the whole system is retrieved through the femoral sheath. G) The retrieved deformed stent (white block arrow) did not…

Figure 3. The angiographic images show LSD in an undeployed stent and its retrieval using a snare. The RAO/caudal view shows: A) significant stenosis in the LCX-OM1 with critical stenosis in the distal OM1 (white line arrows). B) This angiographic image shows post-lesion pre-dilation with a 2.5 mm × 15 mm semi-compliant balloon. C) The GC with a longitudinally deformed Orsiro Stent (2.5 mm × 33 mm), which is lodged at the tip, is brought into the femoral sheath (white arrow). D) A snare was used to grasp the deformed stent. E). The stent was pulled back through the femoral sheath en bloc. F) The final angiography after the stenting of the proximal LCX shows brisk TIMI grade 3 flow in the LCX- OM1. G & H) The retrieved longitudinally deformed stent (white block arrow) is on the balloon.