title: Stent loss during chronic total occlusion percutaneous coronary intervention: Optical coherence tomography-guided stent 'crushing and trapping'.
abstract: Stent loss during percutaneous coronary intervention (PCI) is a rare event, which however has been associated with devastating consequences. Adequate management of this complication requires an exact understanding of the location of the lost stent and underlying mechanisms. Our case reports on a 55-year-old man who underwent PCI to a chronic total occlusion of the left anterior descending artery, complicated by stent loss. Successful management involved crushing and trapping of the stent behind a newly implanted stent. The use of optical coherence tomography proved invaluable, clarifying the relationship of the lost stent with side branches, allowing choosing a larger balloon for stent crushing, and suggesting a possible cause for stent loss. Finally, we provide a review on recent literature on stent loss during PCI and offer an algorithm to guide its management.
authors.affiliation: Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy; Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy; Cardiology Department, Hammersmith Hospital, Imperial College London, UK.
authors.forename: Luciano
authors.initials: L
authors.lastname: Candilio
authors.affiliation: Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy; Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy.
authors.forename: Satoru
authors.initials: S
authors.lastname: Mitomo
authors.affiliation: Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Carlino
authors.affiliation: Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy; Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Colombo
authors.affiliation: Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy. Electronic address: azzalini.lorenzo@hsr.it.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Azzalini
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000295:instrumentation*; D002908:Chronic Disease; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000000981:diagnostic imaging / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D054855:Drug-Eluting Stents; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D011475:Prosthesis Failure; D041623:Tomography, Optical Coherence
keywords: Optical coherence tomography; Percutaneous coronary intervention; Stent loss