A dislodged coronary stent migrating over a guiding catheter: a “Muckers-type” stent loss retrieved using a snare technique

Coronary stent dislodgement is a rare complication of percutaneous coronary interventions with potentially serious clinical sequelae. There are several scenarios for the dislodgement and various techniques to deal with this complication. A dislodged stent migrating retrogradely over a guiding catheter and retrieved with a snare system has never been reported. We present the first reported case of a dislodged coronary stent passing over a guiding catheter which was successfully retrieved with a snare system. A 76-year-old patient with unstable angina was admitted for a coronary angiography. It revealed in-stent restenosis in the mid portion of the left anterior descending artery (LAD) and within the ostium of the left main coronary artery (LM). Following an uncomplicated PCI of the LAD and during subsequent stent deployment in the LM, the balloon with a mounted stent popped out to the aorta. After the balloon had been pulled back, the stent migrated over the guiding catheter. Consequently, another longer stent was successfully implanted into the LM, and afterwards the dislodged stent was snared and retrieved using an ipsilateral femoral access. The patient was discharged after two days of uneventful hospital stay. The case report demonstrates an unusual course of stent dislodgement passing over a guiding catheter which was successfully retrieved with a snare technique. It underscores the importance of optimal lesion preparation and meticulous vigilance when implanting short stents into LM.