BACKGROUND: Percutaneous treatment of right coronary artery (RCA) ostial lesions is technically challenging due to cardiorespiratory motion. CASE SUMMARY: We describe a 70-year-old man undergoing PCI for an ostial RCA lesion where a forceful cough caused complete stent expansion within the aortic root. The stent remained mechanically engaged to the delivery shaft. A 4.0 × 15 mm balloon was inflated at the guiding catheter tip as a "balloon stopper," enabling controlled retrieval and "peripheral parking" (intentional implantation) in the right brachial artery. DISCUSSION: This case illustrates the technical feasibility of a bailout strategy for selected fully expanded extracoronary stents when guidewire access is maintained. The balloon-stopper technique provided mechanical control during retrieval, while peripheral implantation allowed relocation of the stent when further extraction was considered potentially hazardous.
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Candela et al. (2026) studied this question.
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