Damage to a covered stent by a thrombectomy device.
A 75-year-old with a history of coronary bypass grafting was found to have significant stenoses in a vein graft to the right coronary artery. Symbiot stents, with a polytetrafluoroethylene covering, were used to treat areas in the proximal and middle sections of the graft. The following day, she developed symptoms and signs consistent with an acute inferior infarction. The graft was found to be thrombosed. Thrombectomy was performed using an X-Sizer device, consisting of a helical cutter connected to a vacuum source. This resulted in damage to the stent lining, which led to jamming of the device and subsequent removal of a piece of the stent covering. Treatment was by way of deployment of a long stent within the damaged stent. Recovery was unremarkable. Caution or avoidance of this device appears warranted in the setting of covered stent procedures.
Pate
Gordon
G
Division of Cardiology, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
Carere
Ronald
R
Webb
John
J
D000368:Aged; D001672:Biocompatible Materials / Q000009:adverse effects; D004868:Equipment Failure; D005260:Female; D006083:Graft Occlusion, Vascular / Q000628:therapy*; D006801:Humans; D009203:Myocardial Infarction / Q000209:etiology; D011138:Polytetrafluoroethylene / Q000009:adverse effects; D011475:Prosthesis Failure; D019919:Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods*; D012008:Recurrence; D012086:Reoperation; D015607:Stents / Q000009:adverse effects; D017131:Thrombectomy / Q000009:adverse effects* / Q000295:instrumentation; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000209:etiology / Q000628:therapy
D001672:Biocompatible Materials; D011138:Polytetrafluoroethylene