Percutaneous intervention successfully managed simultaneous iatrogenic left main coronary artery dissection and fully deployed stent dislodgement, with the patient discharged without complications and remained asymptomatic at 8-month follow-up.
Case Report (n=1)
No
Simultaneous iatrogenic LMCA dissection and retrograde stent dislodgement can be successfully managed percutaneously, including intentional deployment of the dislodged stent in a peripheral artery to prevent embolization.
Abstract Background Iatrogenic left main coronary artery (LMCA) dissection and stent dislodgement are rare but potentially life-threatening complications of coronary angiography and percutaneous coronary intervention. Their simultaneous occurrence is extremely uncommon and poses significant technical challenges. Case presentation A 62-year-old man with a history of hypertension developed LMCA dissection accompanied by chest pain during coronary angiography performed via the right radial approach, caused by non-coaxial catheter engagement. To stabilize the dissection, an additional femoral access was obtained. A drug-eluting stent implanted from the circumflex artery to the LMCA adhered to the balloon and migrated retrogradely, becoming lodged at the tip of the guiding catheter. Because retrieval attempts were unsuccessful, the dislodged stent was intentionally implanted into the right brachial artery to prevent distal embolization. The patient remained hemodynamically stable throughout the procedure and was discharged without complications. Conclusions This case represents the first reported instance of simultaneous LMCA dissection and complete retrograde stent dislodgement successfully managed percutaneously without the need for surgical intervention. Prompt recognition, access modification, and careful device manipulation were essential for achieving a favorable outcome.
Sural et al. (2026) conducted a case report in 62-year-old male patient with non-ST elevation myocardial infarction (NSTEMI) complicated by iatrogenic left main coronary artery dissection and fully deployed stent dislodgement during percutaneous coronary intervention (n=1). Percutaneous coronary intervention with stenting of dissected left main and circumflex artery and intentional implantation of dislodged fully deployed stent into right brachial artery was evaluated on Successful management of iatrogenic left main coronary artery dissection and fully deployed stent dislodgement with recovery and no complications. Percutaneous intervention successfully managed simultaneous iatrogenic left main coronary artery dissection and fully deployed stent dislodgement, with the patient discharged without complications and remained asymptomatic at 8-month follow-up.