Unrecoverable stent deformation in the left main: Crush it or remove it?

Serial ostial and distal left main lesions continue to be one of the most difficult tasks for the interventional cardiologist, with many potential complications occurring. We present such a high‐risk percutaneous coronary intervention where immediate stent explantation was deemed necessary because t...

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Bibliographic Details
Published in:Catheterization and cardiovascular interventions 2023-01, Vol.101 (1), p.113-120
Main Authors: Achim, Alexandru, Krivoshei, Lian, Leibundgut, Gregor
Format: Article
Language:English
Subjects:
Coronary Angiography
Coronary Artery Disease - diagnostic imaging
Coronary Artery Disease - therapy
Humans
Implants
left main
longitudinal crush
PCI complication
Percutaneous Coronary Intervention - adverse effects
stent deformation
stent explantation
stent retrieval
Stents
Treatment Outcome
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Summary:Serial ostial and distal left main lesions continue to be one of the most difficult tasks for the interventional cardiologist, with many potential complications occurring. We present such a high‐risk percutaneous coronary intervention where immediate stent explantation was deemed necessary because the metal deformation and high radial strength of the particular stent platform would prevent an acceptable procedural result if it had been crushed to the vessel wall. The aim of this paper was to discuss left main stent deformation, debate the risks and benefits of stent explantation and finally test in‐vitro our theory on “insufficient” crush with stents with high radial strength and compare it with conventional stents. Bench‐testing supports our ad‐hoc explantation decision showing stent underexpansion, recoil, and malapposition, obtaining an inadequate minimal stent area.
ISSN:1522-1946
1522-726X
DOI:10.1002/ccd.30482