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Published online: 2019-03-27
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Peripheral embolisation and retrieval of an everolimus-eluting stent during intervention in a tortuous right coronary artery

Santosh Kumar Sinha, Sunil Tripathi, Anupam Singh, Lokendra Rekwaal, Nishant Kumar Abhishekh
DOI: 10.5603/FC.a2019.0027

open access

Ahead of print
Case Reports
Published online: 2019-03-27

Abstract

A 78 year-old female with dyslipidemia, diabetes, and hypertension as cardiovascular risk factors underwent percutaneous coronary intervention of tortuous, diffusely diseased right coronary artery (90% stenosis) due to chronic stable angina (Canadian Cardiovascular Society class III) despite guideline-directed medical treatment. After predilatation, a 2.75 × 44 mm Xience Expedition everolimus-eluting stent (Abbott, USA) was tracked, which failed and embolised to the right deep femoral artery during its pullback. It was successfully retrieved by an EN snare: 6–10 mm (Merit Medical, USA) by contralateral femoral approach. Lesion was further dilated and successfully stented using a GuideLiner mother–and-child catheter (Vascular Solutions Inc., USA) by deploying two overlapping 2.75 × 33, and 3 × 23 Xience Expedition drug-eluting stents distally and proximally respectively showing proper stent expansion with TIMI-3 coronary flow.This case highlights trackability issues and the importance of adequate lesion preparation before stent deployment in a tortuous vessel with diffuse disease, especially with a very long stent.

Abstract

A 78 year-old female with dyslipidemia, diabetes, and hypertension as cardiovascular risk factors underwent percutaneous coronary intervention of tortuous, diffusely diseased right coronary artery (90% stenosis) due to chronic stable angina (Canadian Cardiovascular Society class III) despite guideline-directed medical treatment. After predilatation, a 2.75 × 44 mm Xience Expedition everolimus-eluting stent (Abbott, USA) was tracked, which failed and embolised to the right deep femoral artery during its pullback. It was successfully retrieved by an EN snare: 6–10 mm (Merit Medical, USA) by contralateral femoral approach. Lesion was further dilated and successfully stented using a GuideLiner mother–and-child catheter (Vascular Solutions Inc., USA) by deploying two overlapping 2.75 × 33, and 3 × 23 Xience Expedition drug-eluting stents distally and proximally respectively showing proper stent expansion with TIMI-3 coronary flow.This case highlights trackability issues and the importance of adequate lesion preparation before stent deployment in a tortuous vessel with diffuse disease, especially with a very long stent.

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Keywords

chronic stable angina; EN snare, guideliner catheter; stent dislodgement; stent embolisation

About this article
Title

Peripheral embolisation and retrieval of an everolimus-eluting stent during intervention in a tortuous right coronary artery

Journal

Folia Cardiologica

Issue

Ahead of print

Published online

2019-03-27

DOI

10.5603/FC.a2019.0027

Keywords

chronic stable angina
EN snare
guideliner catheter
stent dislodgement
stent embolisation

Authors

Santosh Kumar Sinha
Sunil Tripathi
Anupam Singh
Lokendra Rekwaal
Nishant Kumar Abhishekh

References (7)
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