Management of a Fully Deployed Coronary Stent Migrated to the Left Main Artery

Abstract

Migration of a coronary stent is an uncommon but potentially dangerous event during percutaneous coronary intervention (PCI), and it is even rarer once the stent has been fully deployed. We describe a 39-year-old man presenting with non-ST elevation myocardial infarction (NSTEMI) who underwent PCI of the left circumflex artery (LCx). After implantation, a drug-eluting stent unexpectedly migrated backward into the left main coronary artery (LMCA). An attempt to capture it with a snare via the femoral approach was unsuccessful. Using a balloon anchoring maneuver, the stent was carefully advanced to the radial artery and fixed in position with an additional stent, preserving arterial flow. PCI of the LCx was then completed with a good angiographic outcome. This case underlines the importance of choosing an appropriate stent size, recognizing predisposing factors such as vessel spasm, and being familiar with different retrieval or management techniques to deal with such rare complications.