1
|
Bouziane Z, Malikov S, Bracard S, Fouilhé L, Berger L, Settembre N. Endovascular Treatment of Aortic Arch Vessel Stent Migration: Three Case Reports. Ann Vasc Surg 2019; 59:313.e11-313.e17. [DOI: 10.1016/j.avsg.2019.01.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 01/16/2019] [Accepted: 01/19/2019] [Indexed: 11/25/2022]
|
2
|
Zvavanjanja RC. Percutaneous retrieval of migrated Viabahn stent from a segmental pulmonary artery. CVIR Endovasc 2019; 1:1. [PMID: 30652134 PMCID: PMC6319534 DOI: 10.1186/s42155-018-0007-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 04/05/2018] [Indexed: 12/25/2022] Open
Abstract
Background With improving and aggressive endovascular venous and dialysis techniques there is increasing use of stent grafts with different platforms available on the market. Inappropriately sized stents may displace and potentially end up in the heart or lungs as potential dangerous foreign bodies. There is single published case of successful viabahn stent graft retrieval from the pulmonary circulation. Case presentation We present a patient who had successful safe percutaneous retrieval of a migrated Viabahn stent from a segmental Pulmonary artery and describe a different novel safe technique of successful stent graft retrieval from the pulmonary artery with very low risk to potential damage to the cardiac valve complex. Conclusion This case report demonstrates that Viabahn stent grafts can be safely retrieved from the pulmonary arterial system using this endovascular technique that will significantly reduce the risk of damage to the cardiac valve complex therefore avoiding potential complex surgery. Electronic supplementary material The online version of this article (10.1186/s42155-018-0007-3) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- R C Zvavanjanja
- Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston, McGovern Medical School, 6431 Fannin St, MSB 2.132, Houston, TX 77030 USA
| |
Collapse
|
3
|
Lee JS, Kim HL, Seo JB, Lim WH, Kang EG, Chung WY, Kim SH, Jo ZH, Kim MA. Re-mobilization of Lost Coronary Stent From the Axillary Artery to the Femoral Artery. J Lipid Atheroscler 2016. [DOI: 10.12997/jla.2016.5.1.87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Jeong Seok Lee
- Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Hack-Lyoung Kim
- Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jae-Bin Seo
- Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Woo-Hyun Lim
- Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Eun Gyu Kang
- Department of Internal Medicine, Hongik Hospital, Seoul, Korea
| | - Woo-Young Chung
- Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Sang-Hyun Kim
- Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Zoo-Hee Jo
- Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Myung-A Kim
- Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
4
|
Porto I, Larosa C, Rosa I, Burzotta F, Trani C. Successful transradial removal of an inflated coronary stent dislodged from the right coronary ostium. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2014; 15:432-5. [PMID: 24929473 DOI: 10.1016/j.carrev.2014.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Revised: 04/22/2014] [Accepted: 05/01/2014] [Indexed: 12/01/2022]
Abstract
We describe our solution to the unusual situation of an inflated, large coronary stent (3.5 mm diameter) which became dislodged from the ostium of the right coronary artery after deployment during a transradial procedure. We discussed tips for retrieval from the radial artery while preserving the access for completion of the procedure.
Collapse
Affiliation(s)
- Italo Porto
- Cardiovascular and Neurologic Department, San Donato Hospital, Arezzo, Italy.
| | | | | | | | - Carlo Trani
- Catholic University of the Sacred Heart, Rome, Italy
| |
Collapse
|
5
|
Woodhouse JB, Uberoi R. Techniques for Intravascular Foreign Body Retrieval. Cardiovasc Intervent Radiol 2012; 36:888-97. [DOI: 10.1007/s00270-012-0488-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Accepted: 09/03/2012] [Indexed: 11/30/2022]
|
6
|
Kim W, Kim YH, Lim SY, Kim SH, Ahn JC, Song WH. Retrieval of a partially degloved stent strut during percutaneous coronary intervention. Chonnam Med J 2012; 48:130-2. [PMID: 22977756 PMCID: PMC3434794 DOI: 10.4068/cmj.2012.48.2.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Revised: 07/18/2012] [Accepted: 07/23/2012] [Indexed: 11/17/2022] Open
Abstract
Although stent entrapment is a rare event during percutaneous coronary intervention, stent entrapment can cause stent breakage or loss, which results in fatal complications such as stent embolism or acute myocardial infarction. We report one case of stent entrapment that was successfully treated by a snare via a contralateral transfemoral approach.
Collapse
Affiliation(s)
- Woohyeun Kim
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | | | | | | | | | | |
Collapse
|
7
|
Wani SP, Rha SW, Park JY, Poddar KL, Wang L, Ramasamy S, Moon JM, Kim JB, Ryu SR, Shin SY, Choi UJ, Choi CU, Lim HE, Kim JW, Kim EJ, Park CG, Seo HS, Oh DJ. A novel technique for retrieval of a drug-eluting stent after catheter break and stent loss. Korean Circ J 2010; 40:405-9. [PMID: 20830255 PMCID: PMC2933466 DOI: 10.4070/kcj.2010.40.8.405] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2009] [Accepted: 11/04/2009] [Indexed: 11/11/2022] Open
Abstract
Break of a stent delivery catheter and subsequent stent loss (SL) has been a rare event in the drug-eluting stent (DES) era. We here report a case of successful retrieval of a stent after a break if the delivery catheter and SL from a balloon catheter at a culprit lesion. We finally resolved this situation using a simple balloon technique for both the broken stent catheter inside of the guide catheter and the unexpanded stent in the culprit lesion. Thus balloons are an important weapon in our armamentarium in the cardiac catheterization laboratory for urgent retrieval of a lost stent. Their apt use definitely allowed our patient to avoid undergoing emergency cardiovascular thoracic surgery.
Collapse
Affiliation(s)
- Sunil P Wani
- Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Hondo T, Eno S, Matsuda K, Kisaka T, Sairaku A. Successful retrieval of a dislodged paclitaxel-eluting coronary stent in the abdominal aorta using a Günther Tulip Vena Cava MReye Filter Retrieval Set. J Cardiol Cases 2009; 1:e63-e65. [PMID: 30615750 DOI: 10.1016/j.jccase.2009.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2009] [Revised: 07/29/2009] [Accepted: 08/03/2009] [Indexed: 10/20/2022] Open
Abstract
Although the incidence of stent dislodgement has gradually decreased, dislodgement is still a potential cause of serious complications if it happens. We report a case of complicated dislodgement of a paclitaxel-eluting coronary stent during percutaneous coronary intervention and the successful retrieval in the abdominal aorta using a Günther Tulip Vena Cava MReye Filter Retrieval Set, which was inserted from the right femoral artery. This retrieval set has a unique curve loop that was useful to retrieve the dislodged stent in the abdominal aorta.
Collapse
Affiliation(s)
- Tatsuya Hondo
- Department of Cardiology, Chugoku Rosai Hospital, 1-5-1 Hirotagaya, Kure-shi, Hiroshima 737-0193, Japan
| | - Shin Eno
- Department of Cardiology, Chugoku Rosai Hospital, 1-5-1 Hirotagaya, Kure-shi, Hiroshima 737-0193, Japan
| | - Keiji Matsuda
- Department of Cardiology, Chugoku Rosai Hospital, 1-5-1 Hirotagaya, Kure-shi, Hiroshima 737-0193, Japan
| | - Tomohiko Kisaka
- Department of Cardiology, Chugoku Rosai Hospital, 1-5-1 Hirotagaya, Kure-shi, Hiroshima 737-0193, Japan
| | - Akinori Sairaku
- Department of Cardiology, Chugoku Rosai Hospital, 1-5-1 Hirotagaya, Kure-shi, Hiroshima 737-0193, Japan
| |
Collapse
|
9
|
Kammler J, Leisch F, Kerschner K, Kypta A, Steinwender C, Kratochwill H, Lukas T, Hofmann R. Long-term follow-up in patients with lost coronary stents during interventional procedures. Am J Cardiol 2006; 98:367-9. [PMID: 16860025 DOI: 10.1016/j.amjcard.2006.01.105] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2005] [Revised: 01/31/2006] [Accepted: 01/31/2006] [Indexed: 10/24/2022]
Abstract
The aim of this retrospective study was to determine the incidence of stent loss during interventional procedures and to identify the associated immediate and long-term consequences of such loss. We evaluated 36 cases in which the stents were prematurely displaced from the stent delivery device. Five stents were completely removed from the vascular system successfully. Five stents could not be retrieved from the coronary circulation and led to significant adverse events in 3 patients, in whom the lost stents were not excluded by the placement of another stent. In 26 patients, peripheral embolism below the renal arteries occurred after successful stent retrieval from the coronary arteries. Of these 26 patients, 1 patient died during hospital stay, unrelated to the peripheral stent loss. Additional follow-up examinations were performed for 20 of the remaining 25 patients. Clinical patient status and the ankle-brachial index were evaluated 59 +/- 30 months after stent loss. All patients were free of any stent-related peripheral ischemic symptoms. We also attempted to determine the exact physical locations of the lost stents using computed tomography during follow-up. In 15 patients, we were able to detect the stent in the peripheral arteries using computed tomography. In conclusion, if stents cannot be retrieved from the coronary system, severe problems may occur. Stent loss with peripheral embolization is asymptomatic in long-term follow-up.
Collapse
Affiliation(s)
- Juergen Kammler
- Cardiovascular Division, General Hospital Linz, Linz, Austria.
| | | | | | | | | | | | | | | |
Collapse
|
10
|
Patterson M, Slagboom T. Intracoronary stent dislodgment: updated strategy enabled by the new generation of materials. Catheter Cardiovasc Interv 2006; 67:386-90. [PMID: 16475180 DOI: 10.1002/ccd.20632] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Stent dislodgment remains a vexing problem in percutaneous coronary intervention. The technological improvements in machine-crimped premounted stents have led to a reduced incidence of dislodgment but may have exacerbated the problem of stent dislodgment (SD). Previous reports describing the management of SD have concentrated predominantly on manually mounted stents. We present a case where the position of a dislodged premounted stent in the distal left main stem was unfavorable for previously described solutions. The problem was elegantly resolved by taking advantage of the improved performance of the current generation of wires and balloons to achieve a rapid first-rate clinical outcome.
Collapse
Affiliation(s)
- Mark Patterson
- Amsterdam Department of Interventional Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
| | | |
Collapse
|
11
|
Portugaller HR, Pabst E, Doerfler OC, Tauss J, Zangrando M, Pilger E, Klein GE. Crimping and repositioning of a maldeployed balloon-expandable arterial stent using a gooseneck snare. J Endovasc Ther 2005; 12:247-51. [PMID: 15823073 DOI: 10.1583/04-1455.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To describe a technique for repositioning a fully deployed iliac stent from the infrarenal aorta into the common iliac artery (CIA). CASE REPORT A 58-year-old man was undergoing treatment for a significant right CIA stenosis when a 7x24-mm Palmaz Genesis medium stent was mistakenly deployed in the infrarenal aorta. With the stent still over the guidewire, an 8x60-mm balloon catheter was placed coaxially in the stent. Via a left groin access, a 6-F vascular sheath was introduced retrograde, and a 2.5-cm Amplatz gooseneck snare was advanced into the infrarenal abdominal aorta and pulled back over the stent. The snare was tightly closed to crimp the stent onto the collapsed balloon; this maneuver was repeated several times until the stent was contracted along its entire length. The balloon/stent assembly was carefully pulled back into the right CIA, and the stent was deployed across the target lesion, although there was overlap of the left CIA. Color duplex sonography at 1 year showed no signs of significant iliac arterial stenoses on either side. The patient reported no claudication. CONCLUSIONS Using a gooseneck snare, fully deployed balloon-expandable iliac stents can be recrimped on a balloon.
Collapse
|
12
|
Affiliation(s)
- Ted Feldman
- Evanston-Northwestern Healthcare, Evanston, Illinois 60201, USA.
| |
Collapse
|
13
|
Kim MH, Cha KS, Kim JS. Retrieval of dislodged and disfigured transradially delivered coronary stent: report on a case using forcep and antegrade brachial sheath insertion. Catheter Cardiovasc Interv 2001; 52:489-91. [PMID: 11285606 DOI: 10.1002/ccd.1109] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We report a case of dislodged and damaged stent during transradial coronary procedure using 6 Fr device, which was successfully retrieved by using a forcep and 8 Fr antegrade brachial sheath. The disfigured and bulky stent can be removed, after their retrieval from the coronary circulation, using a forcep inserted through an 8 Fr brachial artery sheath if the radial artery is deemed too small to accommodate larger sheath.
Collapse
Affiliation(s)
- M H Kim
- Section of Cardiology, Dong-A Medical College, Pusan, South Korea.
| | | | | |
Collapse
|
14
|
Eggebrecht H, Haude M, von Birgelen C, Oldenburg O, Baumgart D, Herrmann J, Welge D, Bartel T, Dagres N, Erbel R. Nonsurgical retrieval of embolized coronary stents. Catheter Cardiovasc Interv 2000; 51:432-40. [PMID: 11108675 DOI: 10.1002/1522-726x(200012)51:4<432::aid-ccd12>3.0.co;2-1] [Citation(s) in RCA: 79] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Embolization of coronary stents before deployment is a rare but challenging complication of coronary stenting. Different methods for nonsurgical stent retrieval have been suggested. There were 20 cases (0.90%) of intracoronary stent embolization among 2,211 patients who underwent implantation of 4,066 stents. Twelve of 1,147 manually crimped stents (1.04%) and eight of 2,919 premounted stents were lost (0.27%, P < 0.01) during retraction of the delivery system, because the target lesion could not be either reached or crossed. Percutaneous retrieval was successfully carried out in 10 of 14 patients (71%) in whom retrieval was attempted. In 10 patients, stent retrieval was tried with 1.5-mm low-profile angioplasty balloon catheters (success in 7/10) and in seven cases with myocardial biopsy forceps or a gooseneck snare (success in 3/7). Three patients (15%) underwent urgent coronary artery bypass surgery after failed percutaneous retrieval, but their outcomes were fatal. In two patients, stents were compressed against the vessel wall by another stent, without compromising coronary blood flow. In two patients, a stent was lost to the periphery without clinical side effects; treatment was conservative in these cases. Embolization of stents before deployment is a rare but serious complication of coronary stenting, with hazardous potential for the patient. Manual mounting of stents is associated with a significantly higher risk of stent embolization. Stent retrieval from the coronary circulation with low-profile angioplasty balloon catheters is a readily available and technically familiar approach that has a relatively high success rate.
Collapse
Affiliation(s)
- H Eggebrecht
- Department of Cardiology, Center of Internal Medicine, University Hospital Essen, Essen, Germany.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Abstract
A potential consequence of unsuccessful stent delivery is dislodgment of the stent from the delivery catheter resulting in embolization. Recently, an angioplasty guidewire incorporating a distal occlusion balloon (GuardWire) has become available. We describe how, when used for the prevention of distal embolization of atheromatous or thrombotic particles, this device may facilitate retention and retrieval of undeployed stents.
Collapse
Affiliation(s)
- J G Webb
- Division of Cardiology, St. Paul's Hospital, University of British Columbia, Vancouver, Canada.
| | | | | |
Collapse
|
16
|
Meisel SR, DiLeo J, Rajakaruna M, Pace B, Frankel R, Shani J. A technique to retrieve stents dislodged in the coronary artery followed by fixation in the iliac artery by means of balloon angioplasty and peripheral stent deployment. Catheter Cardiovasc Interv 2000; 49:77-81. [PMID: 10627373 DOI: 10.1002/(sici)1522-726x(200001)49:1<77::aid-ccd17>3.0.co;2-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
An unwelcome complication of the increasingly applied technique of coronary stenting is stent dislodgment, which may cause arterial occlusion or distal embolization, both with potentially adverse sequel. Stent dislodgment tends to occur when negotiating a tortuous artery with a balloon-mounted stent, especially if the artery is irregularly calcified or when applying a rigid stent. We have successfully applied in several patients at our laboratory a technique to retrieve a dislodged stent from the coronary artery, tow it to the iliac artery, and then deploy it locally by a peripheral balloon when retrieval through the vascular sheath seems impossible. Finally, the retrieved stent is secured by local anchoring with a peripheral stent. This technique was found to be useful and may prevent further complications and more costly interventions and hence result in a more benign clinical course. Cathet. Cardiovasc. Intervent. 49:77-81, 2000.
Collapse
Affiliation(s)
- S R Meisel
- Catheterization Laboratory, Division of Cardiology, Maimonides Medical Center, Brooklyn, New York 11219, USA
| | | | | | | | | | | |
Collapse
|
17
|
Slonim SM, Dake MD, Razavi MK, Kee ST, Samuels SL, Rhee JS, Semba CP. Management of misplaced or migrated endovascular stents. J Vasc Interv Radiol 1999; 10:851-9. [PMID: 10435701 DOI: 10.1016/s1051-0443(99)70127-2] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To report experience with techniques for management of misplaced or migrated endovascular stents. MATERIALS AND METHODS During a 5-year period, percutaneous management of 27 misplaced or migrated endovascular stents (16 Palmaz, 11 Wallstents) in 25 patients was attempted. The 17 venous and 10 arterial stents were rescued from the aorta (n = 9), inferior vena cava (IVC) (n = 4), transjugular intrahepatic portosystemic shunt/IVC (n = 2), right atrium (n = 3), right ventricle (n = 2), pulmonary artery (n = 2), iliac vein (n = 2), iliac artery (n = 1), superior vena cava (n = 1), and superior mesenteric vein (n = 1). RESULTS Stent management was successful in 26 of 27 cases (96%). Eleven stents were removed percutaneously, two were repositioned and removed with a minor surgical procedure, and 13 were repositioned and deployed in a stable alternate location. The only complication was the development of tricuspid insufficiency in the single case in which the procedure failed (4% complication rate). This patient's stent was eventually surgically removed from the right ventricle. CONCLUSION Misplaced or migrated endovascular Palmaz and Wallstents can be effectively managed with few complications by using a variety of percutaneous techniques.
Collapse
Affiliation(s)
- S M Slonim
- Section of Cardiovascular and Interventional Radiology, Stanford University Medical Center, California, USA
| | | | | | | | | | | | | |
Collapse
|
18
|
Lohavanichbutr K, Webb JG, Carere RG, Solankhi N, Jarochowski M, D'yachkova Y, Dodek A. Mechanisms, management, and outcome of failure of delivery of coronary stents. Am J Cardiol 1999; 83:779-81, A9. [PMID: 10080438 DOI: 10.1016/s0002-9149(98)00990-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In a single-center experience, initial failure of attempted stent delivery was relatively infrequent (2.7%) but was associated with increased need for urgent coronary bypass surgery. Delivery failure was more likely with coiled stents and dislodgment from the delivery balloon was more likely with hand-mounted or radiolucent stents.
Collapse
Affiliation(s)
- K Lohavanichbutr
- St. Paul's Hospital, University of British Columbia, Vancouver, Canada
| | | | | | | | | | | | | |
Collapse
|
19
|
Lotze U, Ferrari M, Dannberg G, Kühnert H, Figulla HR. Unexpanded, irretrievable stent in the proximal right coronary artery: successful management with stent graft implantation. Catheter Cardiovasc Interv 1999; 46:344-9. [PMID: 10348137 DOI: 10.1002/(sici)1522-726x(199903)46:3<344::aid-ccd19>3.0.co;2-m] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Stent loss and failure of retrieval are rare; nevertheless, complications have to be taken into account during percutaneous coronary intervention. Here we report a case of an unexpanded, irretrievable Palmaz-Schatz stent in the proximal right coronary artery near to the ostium and the successful management by implanting a synthetic stent graft.
Collapse
Affiliation(s)
- U Lotze
- Department of Internal Medicine III, Friedrich-Schiller-Universität, Jena, Germany. lotze@.polkim.med.uni-jena.de
| | | | | | | | | |
Collapse
|
20
|
Rokas SG, Antonellis IP, Patsilinakos SP, Agrios N, Pamboukas CA, Kranidis AJ, Margaris NG, Bonou M, Tsilias K, Kostopoulos KG, Tavernarakis AG, Stamatelopoulos SF. New method for placement of intracoronary stents in order to avoid their embolization in the intravascular space. CATHETERIZATION AND CARDIOVASCULAR DIAGNOSIS 1998; 45:183-7. [PMID: 9786400 DOI: 10.1002/(sici)1097-0304(199810)45:2<183::aid-ccd17>3.0.co;2-m] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Stent dislodgment from the delivery catheter is a well-known complication of angioplasty with stent implantation. The aim of our study was to investigate the feasibility, effectiveness, and safety of a new technique of intracoronary stent implantation in order to avoid stent loss in the intravascular space. Fifty consecutive patients were candidates for angioplasty and stent placement. During angioplasty, a technique was followed according to which the guide wire "hindered" the dislodgment of the stent from the balloon catheter. Successful angioplasty and stent placement were performed in 46 out of 50 patients (92% success rate). In three cases of failure of stent implantation, the stent moved onto the balloon catheter; however, this was impeded by the guide wire. One non-Q-wave myocardial infarction occurred. No major complications (Q-wave myocardial infarction, CABG, or death) were observed. In conclusion, the technique applied was feasible enough, safe, and effective. However, the appropriate modification of its "hardware" will render it even more feasible and user-friendly.
Collapse
Affiliation(s)
- S G Rokas
- Invasive Cardiology Unit, Alexandra Hospital, Athens, Greece
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
El Feghaly M, Soula P, Rousseau H, Chaiban F, Otal P, Joffre F, Cerene A. Endovascular retrieval of two migrated venous stents by means of balloon catheters. J Vasc Surg 1998; 28:541-6. [PMID: 9737466 DOI: 10.1016/s0741-5214(98)70142-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The usefulness of vascular stenting was demonstrated in both arterial and venous applications to restore patency and improve suboptimal results after percutaneous transluminal angioplasty. Dislodgment of venous stents with an embolization into the right cavities or the pulmonary artery, however, is one of the most feared complications of this procedure. Percutaneous removal of these migrated stents is an appealing method of replacing more invasive operative intervention with cardiopulmonary bypass, which may be very hazardous in these often severely ill patients. We describe the cases of two patients with stents that migrated into the right ventricle and the pulmonary artery. In one patient, we were able to successfully remove these stents by using an angioplasty balloon with an operative extraction from the iliac vein, thereby obviating the need for a major operative procedure.
Collapse
Affiliation(s)
- M El Feghaly
- Division of Cardiovascular Surgery, Rangueil Hospital, Toulouse, France
| | | | | | | | | | | | | |
Collapse
|
22
|
Douard H, Besse P, Broustet JP. Successful retrieval of a lost coronary stent from the descending aorta using a loop basket intravascular retriever set. CATHETERIZATION AND CARDIOVASCULAR DIAGNOSIS 1998; 44:224-6. [PMID: 9637450 DOI: 10.1002/(sici)1097-0304(199806)44:2<224::aid-ccd21>3.0.co;2-l] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Delivery of a balloon-expandable stent was complicated by a systemic embolisation. The radio-opaque stent was lost in the descending aorta, but then removed by using a loop basket intravascular retriever set without any peripheral arterial complication.
Collapse
Affiliation(s)
- H Douard
- Hôpital Cardiologique du Haut Lévèque, Pessac, Bordeaux, France
| | | | | |
Collapse
|
23
|
Hoyer MH, Bailey SR, Neill JA, Palmaz JC. Transcatheter retrieval of an embolized Palmaz stent from the right ventricle of a child. CATHETERIZATION AND CARDIOVASCULAR DIAGNOSIS 1996; 39:277-80. [PMID: 8933972 DOI: 10.1002/(sici)1097-0304(199611)39:3<277::aid-ccd14>3.0.co;2-c] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A young girl in whom a Palmaz stent embolized from the pulmonary artery to the right ventricle during a prior cardiac catheterization underwent successful retrieval and repositioning by a transcatheter technique 8 d later. This technique provides an alternative to surgery when intracardiac embolization of a stent occurs.
Collapse
Affiliation(s)
- M H Hoyer
- Department of Radiology, University of Texas Health Science Center, San Antonio, USA
| | | | | | | |
Collapse
|
24
|
Elsner M, Peifer A, Kasper W. Intracoronary loss of balloon-mounted stents: successful retrieval with a 2 mm-"Microsnare"-device. CATHETERIZATION AND CARDIOVASCULAR DIAGNOSIS 1996; 39:271-6. [PMID: 8933971 DOI: 10.1002/(sici)1097-0304(199611)39:3<271::aid-ccd13>3.0.co;2-i] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Intracoronary loss of balloon-mounted stents prior to deployment is a rare event but may result in clinically relevant cardiac ischemia or peripheral embolization during rescue attempts. In a consecutive series of nearly 400 patients undergoing elective stenting, we encountered six instances of intracoronary misplacement. We describe four cases of successful percutaneous retrieval using a 2 mm closed loop nitinol device ("Microsnare"). Our proposed method of extraction seems to hold advantages over those previously described.
Collapse
Affiliation(s)
- M Elsner
- Medizinische Klinik I (Dep. of Cardiology), St. Josefs Hospital, Wiesbaden, Germany
| | | | | |
Collapse
|
25
|
Popma JJ, Lansky AJ, Ito S, Mintz GS, Leon MB. Contemporary stent designs: technical considerations, complications, role of intravascular ultrasound, and anticoagulation therapy. Prog Cardiovasc Dis 1996; 39:111-28. [PMID: 8841006 DOI: 10.1016/s0033-0620(96)80021-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
A number of studies have shown the benefits of stent placement over balloon angioplasty for the treatment of focal, native coronary artery, and saphenous vein graft disease. Although the number of stent designs available for clinical use has increased dramatically, the late clinical benefit of stenting over balloon angioplasty has yet to be shown in diffuse disease, complex bifurcation stenoses, or smaller (2.5-mm) vessels, each of which may require unique stent designs and adjunct therapies not currently available or extensively studied. The purposes of this review are to discuss the various stent designs currently available for clinical use, outline the known complications associated with these stents, assess the contribution of intravascular ultrasound, and describe current antiplatelet and antithrombotic therapy used after stent use.
Collapse
Affiliation(s)
- J J Popma
- Department of Internal Medicine, Washington Hospital Center, Washington, DC 20010, USA
| | | | | | | | | |
Collapse
|
26
|
Hartnell GG, Jordan SJ. Percutaneous removal of a misplaced Palmaz stent with a coaxial snare technique. J Vasc Interv Radiol 1995; 6:799-801. [PMID: 8541687 DOI: 10.1016/s1051-0443(95)71188-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Affiliation(s)
- G G Hartnell
- Department of Radiological Sciences, Deaconess Hospital, Boston, MA 02215, USA
| | | |
Collapse
|
27
|
Cishek MB, Laslett L, Gershony G. Balloon catheter retrieval of dislodged coronary artery stents: a novel technique. CATHETERIZATION AND CARDIOVASCULAR DIAGNOSIS 1995; 34:350-2. [PMID: 7621548 DOI: 10.1002/ccd.1810340216] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Potential complications of intracoronary stenting include stent dislodgement and embolization. We describe a patient in whom a stent was dislodged from a coronary balloon catheter to the iliac artery. A peripheral angioplasty balloon was used to withdraw the stent into the arterial sheath and thereby remove it from the patient.
Collapse
Affiliation(s)
- M B Cishek
- Division of Cardiovascular Medicine, University of California Davis Medical Center, Sacramento 95817, USA
| | | | | |
Collapse
|
28
|
Bartorelli AL, Fabbiocchi F, Montorsi P, Loaldi A, Tamborini G, Sganzerla P. Successful transcatheter management of Palmaz Stent embolization after superior vena cava stenting. CATHETERIZATION AND CARDIOVASCULAR DIAGNOSIS 1995; 34:162-6. [PMID: 7788697 DOI: 10.1002/ccd.1810340419] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
A 34-year-old patient with benign superior vena cava syndrome (SVCS) was treated with thrombolytic therapy, balloon angioplasty, and placement of two peripheral Palmaz stents. Embolization of one stent to the right atrium occurred 10 min after successful implantation. This serious complication was successfully managed by percutaneous transcatheter technique with retrieval from the right atrium and subsequent deployment into the right external iliac vein of the lost stent. Complete resolution of SVCS symptoms occurred within 24 hr and moderate superior vena cava restenosis was successfully dilated 8 months later. At 12-month follow-up the patient continues to be asymptomatic.
Collapse
Affiliation(s)
- A L Bartorelli
- Istituto di Cardiologia dell'Università degli Studi, Centro di Studio per le Ricerche Cardiovascolari del Consiglio Nazionale delle Ricerche, Fondazione, Monzino IRCCS, Milan, Italy
| | | | | | | | | | | |
Collapse
|
29
|
Feldman T, Carroll JD, Follman DF, al-Hani A, Levin TN. Peripheral arterial angioplasty balloons as adjuncts to percutaneous coronary revascularization. CATHETERIZATION AND CARDIOVASCULAR DIAGNOSIS 1994; 33:110-5. [PMID: 7834722 DOI: 10.1002/ccd.1810330205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Although PTCA balloon technology has improved dramatically since the first catheters were introduced over a decade ago, some limitations remain. The largest conventional balloon size available is 4.0 mm diameter. Larger size balloons are sometimes necessary for saphenous vein graft dilatation or in very large native coronary arteries. Also, adjunctive balloon angioplasty is used frequently after atherectomy and other coronary device therapy. Current generation balloons are not always necessary in this setting, since a large lumen has already been established. Thus, it has become useful in our laboratory to use peripheral arterial angioplasty balloons for both large coronary vessel dilatation, and also for adjunctive dilatation after device use. We describe our initial experience with peripheral arterial angioplasty balloons as adjuncts to percutaneous coronary revascularization.
Collapse
Affiliation(s)
- T Feldman
- University of Chicago Hospital, Pritzker School of Medicine, Hans Hecht Hemodynamics Laboratory, Illinois 60637
| | | | | | | | | |
Collapse
|