Farooqui Azhar, Bajmmal Omar, Farooq Mohsin, Ehtisham Javed, Antoun Ibrahim
Department of Cardiology, Kettering General Hospital, Kettering, United Kingdom.
Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom.
JACC Case Rep. 2025 Mar 5;30(5):103172. doi: 10.1016/j.jaccas.2024.103172.
We describe a case of left main stem (LMS) stent dislodgement and embolization over the guide catheter after an intravascular ultrasound-guided percutaneous coronary intervention to an LMS osteal stenosis. After the initial intravascular ultrasound-guided assessment, the patient underwent percutaneous coronary intervention with 2 overlapping drug-eluting stents. After post-dilation, it was observed that the proximal LMS stent had migrated over the guide catheter proximally and dislodged from its original deployment in the LMS. A 6.0-mm balloon was inflated at the distal end of the guide catheter to prevent stent embolization. The catheter was carefully retrieved until the brachial artery, where the preexpanded stent diameter prevented further retrieval. It was eventually deployed with no immediate complications.
我们描述了一例在对左主干开口处狭窄进行血管内超声引导下经皮冠状动脉介入治疗后，左主干（LMS）支架移位并栓塞至引导导管上方的病例。在最初的血管内超声引导评估后，患者接受了两枚重叠药物洗脱支架的经皮冠状动脉介入治疗。后扩张后，发现近端LMS支架向引导导管近端移位，并从其在LMS的初始植入位置脱出。在引导导管远端充入一个6.0毫米的球囊以防止支架栓塞。小心回撤导管直至肱动脉，此时预扩张支架的直径阻止了进一步回撤。最终支架成功植入，无即刻并发症。
