Balloon-Stopper Retrieval and Peripheral Parking After Inadvertent Ostial Right Coronary Stent Deployment.

BACKGROUND

Percutaneous treatment of right coronary artery (RCA) ostial lesions is technically challenging due to cardiorespiratory motion.

CASE SUMMARY: We describe a 70-year-old man undergoing PCI for an ostial RCA lesion where a forceful cough caused complete stent expansion within the aortic root. The stent remained mechanically engaged to the delivery shaft. A 4.0 × 15 mm balloon was inflated at the guiding catheter tip as a "balloon stopper," enabling controlled retrieval and "peripheral parking" (intentional implantation) in the right brachial artery.

DISCUSSION: This case illustrates the technical feasibility of a bailout strategy for selected fully expanded extracoronary stents when guidewire access is maintained. The balloon-stopper technique provided mechanical control during retrieval, while peripheral implantation allowed relocation of the stent when further extraction was considered potentially hazardous.