Expanded Stent Migration and Renal Artery Embolization During Aorto-Ostial Left Main Percutaneous Coronary Intervention
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초록

BACKGROUND: Stent dislodgement with systemic embolization is a rare but serious complication of percutaneous coronary intervention. METHODS: During intravascular ultrasound-guided percutaneous coronary intervention for aorto-ostial left main artery stenosis, a fully expanded 4.0-mm drug-eluting stent dislodged upon balloon withdrawal. Angiography showed the stent partially floating in the aortic root, with its distal struts still anchored at the ostium, before its complete embolization. After securing the left main artery with a second stent, the dislodged stent was identified following systemic embolization to the left renal artery. Given the high risk of retrieval, it was managed in situ with balloon expansion to achieve full apposition against the vessel wall. CONCLUSIONS: This report describes the rare event of systemic embolization of a fully expanded stent. Our experience indicates that in situ expansion may represent a practical alternative when retrieval poses significant hazards, offering a potential pathway to stabilize the complication. CONCLUSIONS: Fully expanded coronary stents can in rare cases dislodge and embolize systemically. When retrieval is high risk, intentional in situ deployment at the embolization site provides a safe and definitive management option. Copyright © 2025. Published by Elsevier Inc.

키워드

IVUS guidancecoronary stent complicationguidewire lossin situ stent managementinterventional bailout technique
제목
Expanded Stent Migration and Renal Artery Embolization During Aorto-Ostial Left Main Percutaneous Coronary Intervention
저자
Hendrianus, nullLee, Sang YeubJo, JinhwanKim, Sang-Wook
DOI
10.1016/j.jaccas.2025.106327
발행일
2025-12
유형
Case Reports;Journal Article
저널명
JACC. Case reports