Stent retrieval from renal artery by wire twist technique

Abstract

Wire twist technique is an important technique for retrieval of dislodged stent or broken coronary wire in areas where snare cannot be negotiated because of its bulky profile. In our patient dislodged coronary stent had been successfully retrieved from renal artery using twist wire technique. A 59 years gentleman, diabetic, hypertensive and smoker admitted with recent anterior wall myocardial infarction and ongoing chest pain. On coronary angiogram patient had approx. 80% stenosis in proximal LAD and approx. 80% stenosis in large OM1. PCI to LAD done with a 3X24 DES placed from ostium of LAD. But balloon dilation of OM lesion was difficult because of its tortuosity and also a 3X33 stent couldn't be negotiated . During removal of stent balloon came out and the stent was struck and hanging in the LCX to LM to Aorta. It spontaneously dislodged from coronary artery and entered right renal artery. However PCI to OM done with a smaller stent of 3X28 DES. A snare had been tried but couldn't be negotiated through the renal artery using right femoral route and JR(5F) guide cath. As an alternative approach three coronary wires had been passed through the side of the dislodged stent and multiple twisting done through a torquer. Thus the stent was entangled with the wires and the whole system was pulled and removed.