Unrecoverable stent deformation in the left main: Crush it or remove it?

Catheter Cardiovasc Interv. 2023 Jan;101(1):113-120. doi: 10.1002/ccd.30482. Epub 2022 Nov 15.


Serial ostial and distal left main lesions continue to be one of the most difficult tasks for the interventional cardiologist, with many potential complications occurring. We present such a high-risk percutaneous coronary intervention where immediate stent explantation was deemed necessary because the metal deformation and high radial strength of the particular stent platform would prevent an acceptable procedural result if it had been crushed to the vessel wall. The aim of this paper was to discuss left main stent deformation, debate the risks and benefits of stent explantation and finally test in-vitro our theory on "insufficient" crush with stents with high radial strength and compare it with conventional stents. Bench-testing supports our ad-hoc explantation decision showing stent underexpansion, recoil, and malapposition, obtaining an inadequate minimal stent area.

Keywords: PCI complication; left main; longitudinal crush; stent deformation; stent explantation; stent retrieval.

MeSH terms

  • Coronary Angiography
  • Coronary Artery Disease* / diagnostic imaging
  • Coronary Artery Disease* / therapy
  • Humans
  • Percutaneous Coronary Intervention* / adverse effects
  • Stents
  • Treatment Outcome