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Background <p>Percutaneous coronary intervention (PCI) of left main (LM) bifurcation lesions carries a high risk of complications, including stent entrapment, a rare but potentially life-threatening event. Management often requires surgical intervention, though percutaneous techniques can sometimes provide an alternative solution.</p> Case presentation <p>A 63-year-old male with hypertension and diabetes mellitus presented with non-ST elevation myocardial infarction (NSTEMI). PCI was performed using the T and small protrusion (TAP) technique for a 1,1,1 Medina-classified an LM bifurcation lesion. Following deployment of the LM–left anterior descending (LAD) stent, the left circumflex (LCx) stent became entrapped in the LM stent, resulting in fracture and shaft separation during attempted retrieval. A stepwise approach was used: (1) multiple balloon inflations to loosen the entrapped stent; (2) shaft trapping within the guide catheter; and (3) en bloc removal of the system. Final correction included deploying an additional stent to address LM stent deformation. The patient remained stable with no post-procedural complications.</p> Conclusions <p>This case highlights the “loosen, trap, and pull” technique as a viable percutaneous alternative for retrieving an entrapped stent within a previously deployed LM stent, potentially avoiding the need for emergent surgical intervention.</p>

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Loosen, trap, and pull technique for retrieval of an entrapped stent in a previously stented left main coronary artery

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月22日

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  • Ahmed M. Khairy,
  • Ahmed Emara,
  • Ameer Awashra,
  • Ahmed Ali Fahim,
  • Abdelaziz Sheridah,
  • Sameh Nassar

摘要

Background

Percutaneous coronary intervention (PCI) of left main (LM) bifurcation lesions carries a high risk of complications, including stent entrapment, a rare but potentially life-threatening event. Management often requires surgical intervention, though percutaneous techniques can sometimes provide an alternative solution.

Case presentation

A 63-year-old male with hypertension and diabetes mellitus presented with non-ST elevation myocardial infarction (NSTEMI). PCI was performed using the T and small protrusion (TAP) technique for a 1,1,1 Medina-classified an LM bifurcation lesion. Following deployment of the LM–left anterior descending (LAD) stent, the left circumflex (LCx) stent became entrapped in the LM stent, resulting in fracture and shaft separation during attempted retrieval. A stepwise approach was used: (1) multiple balloon inflations to loosen the entrapped stent; (2) shaft trapping within the guide catheter; and (3) en bloc removal of the system. Final correction included deploying an additional stent to address LM stent deformation. The patient remained stable with no post-procedural complications.

Conclusions

This case highlights the “loosen, trap, and pull” technique as a viable percutaneous alternative for retrieving an entrapped stent within a previously deployed LM stent, potentially avoiding the need for emergent surgical intervention.