Finding Safe Haven for a Migrated Left Main Coronary Stent

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.