Retrieving a Peripherally Dislodged Coronary Stent: A Last Resort Approach

A middle-aged man in his 50s with a history of percutaneous coronary intervention (PCI) in the left main coronary artery (LMCA) and right coronary artery presented with worsening exertional angina. Invasive coronary angiography revealed a significant diffuse lesion distal to the LMCA stent in the proximal left anterior descending (LAD) artery, prompting a decision to proceed with PCI. During the procedure, the stent detached from the balloon and became lodged at the proximal LMCA stent, resulting in hemodynamic collapse. In an attempt to stabilize the patient, the entire guiding catheter, along with the stent-balloon assembly and coronary wire, was withdrawn through the radial sheath. However, the stent became dislodged and migrated to the right brachial artery. After multiple unsuccessful percutaneous retrieval attempts, surgical removal via brachial arteriotomy was successfully performed.