Accidental stenting out of stent: A lesson from no-reflow after new stent deployment outside the prior stent

Chih Hung Lai, Shih Hsien Sung, Wen Lieng Lee, Yu Hsiang Juan, Szu Ling Chang, Tse Min Lu*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

An operator can be unaware that the guide wire has accidentally advanced into space outside the previous stent, which can result in deformation of the previous stent when a new stent is deployed outside the prior stent. We herein have reported a case of accidental guide wire advancement into a previously dissected lumen of right coronary artery (RCA), resulting in a new stent deploying outside the prior stent, resulting in deformity of the prior stent. Thrombus and friable atheromatous plaques dislodged andmigrated to occlude distal RCA when attempting to restore the proximal luminal diameter by balloon inflation, resulting in profound shock with asystole. IVUS was successful in identifying the cause, and the thrombus was removed successfully by manual aspiration. Due to the poor endothelization of a recent stenting, clinicians should be particularly careful of possible wire advancing outside the stent structure, which can result in prominent thrombus or atheromatous debris occluding the distal vessel, and IVUS may be useful in confirming the cause of no-reflow.

Original languageEnglish
Pages (from-to)367-370
Number of pages4
JournalActa Cardiologica Sinica
Volume32
Issue number3
DOIs
StatePublished - May 2016

Keywords

  • Coronary dissection
  • Intravascular ultrasound
  • No reflow
  • Recent myocardial infarction
  • Stent deformation

Fingerprint

Dive into the research topics of 'Accidental stenting out of stent: A lesson from no-reflow after new stent deployment outside the prior stent'. Together they form a unique fingerprint.

Cite this