J Lipid Atheroscler.  2015 Dec;4(2):149-152. 10.12997/jla.2015.4.2.149.

Undermining and Ballooning the Proximal Part of the Left Main Coronary Artery Stent Resulting in an Iatrogenic Stent Deformation

• Jeong HS
• Hong SJ
• Hwang SH
• Ko KH
• Hwang TY
• Yu CW
• Lim DS

• KMID: 2151825
• DOI: http://doi.org/10.12997/jla.2015.4.2.149

Abstract

We present a case of a 52-year-old woman with iatrogenic stent deformation occurred after deployment of the left main (LM) stent due to the unintentional undermining of the proximal part of the LM stent with subsequent balloon dilatation. We tried to crush the deformed part of the LM stent against the left coronary cusp by pushing it with a guiding catheter. The deformed stent was stabilized after stent crushing and the patient didn't have any cardiovascular events. This case highlights that stent deformation could be successfully managed by crushing the deformed part of the stent to the coronary sinus.

Keyword

Coronary Angiography; Stent Deformation; Multidetector Computed Tomography

MeSH Terms

Catheters
Coronary Angiography
Coronary Sinus
Coronary Vessels*
Dilatation
Female
Humans
Middle Aged
Multidetector Computed Tomography
Stents*

Figure

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  Fig. 1 (A) Coronary angiogram shows that the Choice PT wire undermined the proximal part of left main stent. (B) Deformed left main stent was hanging at the left coronary cusp.

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  Fig. 2 (A) Intravascular ultrasound (IVUS) showed the deformed stent protruding to the left coronary cusp, (B) Follow-up IVUS showed the crushed stent struts (arrows) toward the left coronary cusp.

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  Fig. 3 (A) Crushing the deformed part against the left coronary cusp by pushing the protruded stent with the guiding catheter, (B) Coronary angiogram showed the crushed stent.

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  Fig. 4 (A) The three-dimensional (3D) contrast-enhanced coronary CT angiography showed a segment (4 mm in size) of the left main coronary stent protruding from the coronary artery orifice into the aorta after crushing the deformed part with the guiding catheter, (B) 3D contrast-enhanced coronary CT angiography showed the crushed stent at oblique view. Arrows indicate stent struts.

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