PMC7849840_01
Occluded mid left anterior descending artery (culprit lesion) in the setting of an acute anterior wall ST elevation myocardial infarction.
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The procedure was performed transradially with 6Fr system and showed high-grade stenosis of the distal left circumflex and distal right coronary artery and determined the culprit to be an occluded left anterior descending artery (LAD) (Fig. 1).
A: The guiding catheter, the damaged stent, and the wire assembly in the radial artery. The proximal stent struts got crumpled B: second wire got entangled and snipped, C: the stent and a fractured guidewire were deployed in situ, D: Good result and no complications.
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In the radial artery, focused inspection of the stent under fluoroscopy showed that the proximal stent struts got crumpled with clear separation from the proximal balloon marker (Fig. 2a). We tried to pass another wire parallel to the stent in an attempt to deliver a balloon and crush the distorted part of the stent to make it retrievable through 6Fr guiding catheter, but this wire got entangled with the protruding stent struts and snipped (Fig. 2b). As the patient experienced chest discomfort, the stent and a remnant filament of fractured guidewire were deployed in situ (Fig. 2c) with excellent result and no immediate complications (Fig. 2d) apart from very minimal instant forearm pain that resolved spontaneously within a few minutes.
Transfemoral approach with successful deployment of a new BioMime 3.0-2.5 x 60 mm stent.
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The intervention was continued using the transfemoral approach with successful deployment of a new BioMime (Merillife science, Vapi, Gujarat, India) 3.0-2.5 x 60 mm stent (see Fig. 3).