JACC. Case reports · 2025
When the Shaft Breaks: Managing a Cath Lab Nightmare.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
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Oliveira Catarina, Raposo Miguel, Marques da Costa José, Pinto Fausto J, Silva Marques João
Аннотация
OBJECTIVE: We describe the case of a 57-year-old male patient with anterior ST-segment elevation myocardial infarction in cardiogenic shock. Coronary angiography revealed severe left main (LM) and triple-vessel disease, and the patient was refused for surgery due to lack of distal grafting landing zone. A shaft fracture occurred during LM percutaneous coronary intervention, leaving the fractured stent hanging in the aorta. This case highlights the successful retrieval of the fractured stent shaft using a snare technique.Key steps include coronary protection and bailout fixing with a stent in LM artery and use of snare technique to retrieve the shaft from the aorta.
POTENTIAL PITFALLS: Operators should avoid pulling the system when stent entrapment occurs.
TAKE-HOME MESSAGES: Bailout access through the Impella sheath can be used in complication management. When stent entrapment occurs, use balloon trapping instead of pulling the entire system and protect coronary arteries with guidewires before proceeding with shaft extraction.
POTENTIAL PITFALLS: Operators should avoid pulling the system when stent entrapment occurs.
TAKE-HOME MESSAGES: Bailout access through the Impella sheath can be used in complication management. When stent entrapment occurs, use balloon trapping instead of pulling the entire system and protect coronary arteries with guidewires before proceeding with shaft extraction.