Book review
https://doi.org/10.20471/acc.2024.63.s1.15
Stent Dislodgement during Primary Percutaneous Coronary Intervention in Patient with Myocardial Infarction and Pulmonary Embolism: A Case Report
Mateja Sabol Pušić
; 1Cardiology with coronary care unit, County hospital Čakovec, Čakovec, Croatia
*
Branko Ostrički
; 1Cardiology with coronary care unit, County hospital Čakovec, Čakovec, Croatia
Mihajlo Kovačić
; 1Cardiology with coronary care unit, County hospital Čakovec, Čakovec, Croatia
* Corresponding author.
Abstract
A 74-year-old patient was hospitalized because of pulmonary embolism and deep
venous thrombosis. Standard medication therapy was administered but the inferolateral ST elevation
myocardial infarction (STEMI) occurred only a few hours after the admission. Coronary angiography
was performed, and circumflex artery (ACx) occlusion verified. Initially, thromboaspiration was done,
the lesion was predilated with a semi-compliant (SC) balloon and drug eluting stent (DES) was
placed. The control angiogram showed a filling defect at the occlusion site, while the expanded stent
was visualized in the left main (it did not adequately detach during inflation and was pulled retrograde
to the guide catheter). We attempted to remove the stent by passing an SC balloon over the stent and
it was pulled under fluoroscopic guidance to the brachial artery. An effort was then made to extract
the stent using ˝twisting guide wire technique˝, but without success. Finally, the stent was grasped
with an EN Snare® device and removed completely through the sheath. The procedure ended with the
repositioning of the guide catheter and implantation of a new stent. In further hospitalization, gastroenterological
workup was planned, but because of septic shock and COVID infection, the patient
died due to multiorgan failure.
Keywords
Stent; Device removal; Percutaneous coronary intervention; Acute coronary syndrome; Complications
Hrčak ID:
321252
URI
Publication date:
1.3.2024.
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