Catheterization and Cardiovascular Interventions 84:677–681 (2014)
Case Report Myocardial Infarction Due to Intracoronary Embolization of Percutaneous Coronary Intervention Packaging Andrew W. Ertel, MD, Adhir R. Shroff, MD, MPH, FACC, FSCAI, and Mladen I. Vidovich,* MD, FACC, FSCAI Intracoronary device loss is occasionally encountered and removal is commonly performed at the time of the procedure. We report a case of removal of a retained coronary balloon protective plastic tubing inadvertently left in the coronary artery for a month and associated with myocardial infarction. Optical coherence tomography was used to visualize the foreign body prior to removal with a snare. To our knowledge this is the first report of a removal of disposable packaging equipment after prolonged intracoronary dwell time. VC 2014 Wiley Periodicals, Inc. Key words: foreign body; myocardial infarction; percutaneous coronary intervention
INTRODUCTION
Removal of intracoronary foreign bodies is an uncommonly performed procedure. Traditionally, the retained object is due to dislodged stents or equipment manufacturing defects. Such equipment loss may occur owing to challenging coronary anatomy or vigorous equipment manipulation. After recognition of such a procedural complication, the extraction is traditionally performed in the same procedural setting. It is, however, exceedingly uncommon to encounter previously inadvertently retained foreign objects during cardiac catheterization. We report a case of foreign body removal in a patient who had undergone percutaneous coronary intervention (PCI) a month prior at another institution and presented to our cardiac catheterization laboratory with non-ST elevation myocardial infarction.
a severe stenosis in the proximal left anterior descending artery (LAD) was found and treated with a drugeluting stent. In our Emergency Department, the patient noted that he had been having periodic episodes of substernal chest discomfort since the initial stent placement. These episodes were non-exertional and lasted about 5 min. He was compliant with his cardiac medications including aspirin, clopidogrel, metoprolol, and simvastatin. Vital signs and physical examination were unremarkable. His electrocardiogram (ECG) showed diffuse deep T-wave inversions but no Q waves. His troponin was elevated at 5.1 ng/mL.
Division of Cardiology, Jesse Brown Veterans Administration Medical Center and University of Illinois Hospital and Health Sciences System, Chicago, Illinois
CASE REPORT
Conflict of interest: Nothing to report.
In June of 2012, a 76-year-old patient with hypertension, hyperlipidemia, and tobacco abuse presented to our outpatient cardiology clinic for follow-up care. One month prior, he had presented to another hospital with syncope, abdominal pain, and dizziness, and was ultimately diagnosed with an acute coronary syndrome with a peak troponin level of 2.9 ng/mL. At that time,
*Correspondence to: Mladen I. Vidovich; 840 S Wood St, MC 715, Suite 935, Chicago, IL 60612. E-mail: [email protected] Received 6 December 2013; Revision accepted 5 February 2014 DOI: 10.1002/ccd.25427 Published online 8 February 2014 in Wiley Online Library (wileyonlinelibrary.com)
Published 2014. This article is a U.S. Government work and is in the public domain in the USA.
678
Ertel et al.
Fig. 1. A. Coronary angiogram demonstrating circular filling defect (arrow). B. Coronary angiogram demonstrating longitudinal filling defect (arrow).
In view of his presenting symptoms, troponin elevation and recent PCI, we performed urgent coronary angiography. To our surprise, a large filling defect extending proximally from the mid-portion of the LAD stent into the left main coronary artery was appreciated (Fig. 1). At the time of cardiac catheterization, we had no access to the previous angiograms nor the procedure report. Due to the unusual appearance of the filling defect, we performed optical coherence tomography (OCT) (IlumienTM PCI OptimizationTM System with DragonflyTM C7 OCT Imaging Catheter, St. Jude Medical, Minneapolis, MN), which revealed a 3 mm 7 mm tubular structure with adherent thrombus pinned beneath the midportion of a malapposed stent and extending into the left main coronary artery (Fig. 2). This was felt to represent a ‘man-made’ foreign body introduced into the coronary circulation during his previous PCI. Procedural Details
Initial diagnostic angiography was performed through right radial approach with 5 F diagnostic catheters. For OCT imaging we upsized to a 6 F guiding catheter and used a 300 cm coronary wire. For the extraction procedure, we upsized and exchanged to a 7 F guide over the 300 cm coronary wire. The guide was exchanged over the long coronary wire to reliably maintain intracoronary wire position since OCT imaging confirmed the coronary wire was not placed under the recently placed stent struts nor through the foreign body. Through a 4 F multipurpose diagnostic catheter we then inserted the snare (Amplatz GooseNeckV R
Snare Kit, 10 mm loop diameter, 4 F, ev3 Endovascular, Plymouth, MN) and advanced it through the 7 F guide parallel to the coronary guide wire. The snare was placed around the foreign body, stabilized by withdrawing the snare into the 4 F multipurpose catheter and the foreign body was easily retrieved while maintaining the coronary wire position (Fig. 3). The 7 F guide catheter and the coronary wire were left in place. Visual inspection of the foreign body revealed that it consisted of protective plastic tubing that is routinely included in coronary balloon or stent packaging but removed prior to device insertion (Fig. 4). After the retrieval procedure, OCT imaging was repeated and demonstrated a severely malapposed and under-expanded stent with a residual white thrombus ‘cast’ that had formed around the plastic tubing (Fig. 5). Due to the unusual characteristics of the thrombus and stent appearance, we chose not to perform aspiration thrombectomy. We placed a drug-eluting stent in the LAD and then post-dilated the previously placed stent. Final OCT imaging demonstrated optimal stent apposition and expansion. His troponin peaked at 9.8 ng/mL. An echocardiogram performed the day after PCI revealed overall preserved left ventricular function with a small area of hypokinesis isolated to the apex. He was discharged home 2 days later. We subsequently obtained and reviewed the report and the initial procedural angiographic images. At the conclusion of the procedure, the operator did observe “a linear density” and after several additional angiographic projections concluded it was due to an “overlapping vessel”. We hypothesize that the plastic tubing had been
Catheterization and Cardiovascular Interventions DOI 10.1002/ccd. Published on behalf of The Society for Cardiovascular Angiography and Interventions (SCAI).
Coronary Foreign Body Extraction
Fig. 2. A. Optical coherence tomography demonstrating foreign body (white arrow). In the longitudinal view, red arrow demonstrates location of foreign body extending into left main coronary artery across the ostium of left circumflex coronary artery (red asterisk). B. Optical coherence tomography demonstrating
Fig. 3. Share extraction of protective plastic tubing via right radial approach.
introduced at the time of pre-dilation and was likely coronary balloon protective tubing. This is consistent with the location of the foreign body we found - underneath the stent struts and extending proximally into the left main coronary artery. It is similarly plausible that after the introduction of the plastic tubing the lesion had been re-wired to allow placement of the stent.
679
foreign body (large arrow) and malapposed stent struts covering the foreign body (small arrows). In the longitudinal view, red arrow demonstrates location of foreign body in the proximal left anterior descending coronary artery. [Color figure can be viewed in the online issue, which is available at wileyonlinelibrary.com.]
Fig. 4. Removed foreign body attached to snare retrieval device (shown alongside reference plastic tubing from stent used during second PCI). [Color figure can be viewed in the online issue, which is available at wileyonlinelibrary.com.]
DISCUSSION
Intracoronary device loss and foreign body embolization are fortunately rare events. The vast majority of intracoronary foreign bodies are stents that have
Catheterization and Cardiovascular Interventions DOI 10.1002/ccd. Published on behalf of The Society for Cardiovascular Angiography and Interventions (SCAI).
680
Ertel et al.
Fig. 5. Optical coherence tomography demonstrating residual thrombus “cast” after foreign body extraction (white arrow). This appearance is consistent with white thrombus due to its homogeneous backscattering and low signal attenuation [12]. In the longitudinal view, red arrow demonstrates location of residual thrombus in proximal left anterior descending coronary artery. [Color figure can be viewed in the online issue, which is available at wileyonlinelibrary.com.]
become dislodged from their delivery equipment. More rarely, intracoronary balloon, catheter, and guidewire fragments may fracture and embolize into the coronary arteries. In the past, the incidence of device loss was as high as 1–8%; however, in contemporary practice, where stents are no longer mounted by hand in the catheterization laboratory, this has declined to around 0.1% [1–7]. Device loss and foreign body embolization in the coronary circulation are typically recognized at the time of the index procedure and treated promptly. To our knowledge, this is the first case report of disposable protective packaging becoming lodged in the coronary artery during a procedure and left in situ for a prolonged period of time. A number of retrieval techniques for intracoronary foreign bodies have been developed over the years, ranging from open chest surgery to minimally invasive approaches including the loop snare retrieval system that was used in this case [8]. Large studies of outcomes in this patient population are quite limited given the infrequent nature of these events and likely publication bias. While some earlier work suggested an increased complication rate in patients with intracoronary device loss, more recent studies suggest an overall benign post-procedure clinical course [1]. We feel that the use of OCT in this case afforded us the level of diagnostic intracoronary imaging accuracy
to help determine the nature of the filling defect [9]. Given the time course and angiographic appearance, the differential diagnosis of a filling defect included intracoronary thrombus or dissection. The high resolution and characterization of the plastic tubing by OCT substantially contributed to favorable outcome. Additionally, it is quite remarkable that the protective plastic tubing was completely visualized and was translucent to the light emitted by the OCT imaging catheter. We reported this event at the time of the procedure through The Department of Veterans Affairs (VA) and The Food and Drug Administration (FDA) joint Device Surveillance Program [10]. This VA-FDA reporting system is embedded in the VA’s electronic medical record system and provides point-of-care unexpected device problem reporting. Postmarkeing surveillance of medical devices in the United States remains largely a voluntary activity and the system in place at the VA offers a more proactive approach to device surveillance [11]. The ‘long-term fate’ of retained plastic tubing in coronary arteries is unknown; however, the patient’s chest pain coupled with the proximal location of the foreign body suggest that serious complications may have been imminent. Our patient recognized the seriousness of his condition and has supported the publication of his quite unique experience. CONCLUSION
In patients presenting with myocardial infarction after recent PCI and uncertain coronary anatomy with unusual filling defects intracoronary imaging is exceptionally useful to determine the etiology of target lesion failure. While exceedingly uncommon, retained foreign bodies need to be considered as cause of myocardial infarction. ACKNOWLEDGMENTS
Each author participated in the clinical care of this patient. Drs. Ertel and Vidovich were responsible for writing and editing the manuscript. Dr. Shroff was responsible for editing the manuscript. There was no funding source related to this manuscript. We specifically thank our patient who actively encouraged us report this procedure and provided written consent. REFERENCES 1. Brilakis ES, Best PJ, Elesber AA, Barsness GW, Lennon RJ, Holmes DR Jr, Rihal CS, Garratt KN. Incidence, retrieval methods, and outcomes of stent loss during percutaneous coronary
Catheterization and Cardiovascular Interventions DOI 10.1002/ccd. Published on behalf of The Society for Cardiovascular Angiography and Interventions (SCAI).
Coronary Foreign Body Extraction
2.
3.
4.
5.
6.
7.
8.
intervention: a large single-center experience. Catheter Cardiovasc Interv 2005;66:333–340. Cantor WJ, Lazzam C, Cohen EA, Bowman KA, Dolman S, Mackie K, Natarajan MK, Strauss BH. Failed coronary stent deployment. Am Heart J 1998;136:1088–1095. Schatz RA, Baim DS, Leon M, Ellis SG, Goldberg S, Hirshfeld JW, Cleman MW, Cabin HS, Walker C, Stagg J, et al. Clinical experience with the Palmaz-Schatz coronary stent. Initial results of a multicenter study. Circulation 1991;83:148–161. Eggebrecht H, Haude M, von Birgelen C, Oldenburg O, Baumgart D, Herrmann J, Welge D, Bartel T, Dagres N, Erbel R. Nonsurgical retrieval of embolized coronary stents. Catheter Cardiovasc Interv 2000;51:432–440. Alfonso F, Martinez D, Hernandez R, Goicolea J, Segovia J, Fernandez-Ortiz A, Banuelos C, Macaya C. Stent embolization during intracoronary stenting. Am J Cardiol 1996;78:833–835. Elsner M, Peifer A, Kasper W. Intracoronary loss of balloonmounted stents: Successful retrieval with a 2 mm-"Microsnare"device. Cathet Cardiovasc Diagn 1996;39:271–276. Foster-Smith KW, Garratt KN, Higano ST, Holmes DR Jr. Retrieval techniques for managing flexible intracoronary stent misplacement. Cathet Cardiovasc Diagn 1993;30:63–68. Bonvini RF, Rastan A, Sixt S, Noory E, Beschorner U, Leppanen O, Mach F, Schwarzwalder U, Burgelin K, Zeller T.
9.
10.
11.
12.
681
Percutaneous retrieval of intravascular and intracardiac foreign bodies with a dedicated three-dimensional snare: A 3-year single center experience. Catheter Cardiovasc Interv 2009;74:939–945. Guagliumi G, Sirbu V, Musumeci G, Gerber R, Biondi-Zoccai G, Ikejima H, Ladich E, Lortkipanidze N, Matiashvili A, Valsecchi O, et al. Examination of the in vivo mechanisms of late drug-eluting stent thrombosis: Findings from optical coherence tomography and intravascular ultrasound imaging. JACC Cardiovasc Interv 2012;5:12–20. Tsai TT, Box TL, Gethoffer H, Noonan G, Varosy PD, Maddox TM, Fihn SD, Gross TP, Jesse RL, Rumsfeld JS. Feasibility of proactive medical device surveillance: The VA Clinical Assessment Reporting and Tracking (CART) program. Med Care 2013;51:S57–S61. Rumsfeld JS, Peterson ED. Achieving meaningful device surveillance: From reaction to proaction. JAMA 2010;304:2065– 2066. Tearney GJ, Regar E, Akasaka T, Adriaenssens T, Barlis P, Bezerra HG, Bouma B, Bruining N, Cho JM, Chowdhary S, et al. Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies: A report from the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation. J Am Coll Cardiol 2012;59:1058–1072.
Catheterization and Cardiovascular Interventions DOI 10.1002/ccd. Published on behalf of The Society for Cardiovascular Angiography and Interventions (SCAI).
Case Report Myocardial Infarction Due to Intracoronary Embolization of Percutaneous Coronary Intervention Packaging Andrew W. Ertel, MD, Adhir R. Shroff, MD, MPH, FACC, FSCAI, and Mladen I. Vidovich,* MD, FACC, FSCAI Intracoronary device loss is occasionally encountered and removal is commonly performed at the time of the procedure. We report a case of removal of a retained coronary balloon protective plastic tubing inadvertently left in the coronary artery for a month and associated with myocardial infarction. Optical coherence tomography was used to visualize the foreign body prior to removal with a snare. To our knowledge this is the first report of a removal of disposable packaging equipment after prolonged intracoronary dwell time. VC 2014 Wiley Periodicals, Inc. Key words: foreign body; myocardial infarction; percutaneous coronary intervention
INTRODUCTION
Removal of intracoronary foreign bodies is an uncommonly performed procedure. Traditionally, the retained object is due to dislodged stents or equipment manufacturing defects. Such equipment loss may occur owing to challenging coronary anatomy or vigorous equipment manipulation. After recognition of such a procedural complication, the extraction is traditionally performed in the same procedural setting. It is, however, exceedingly uncommon to encounter previously inadvertently retained foreign objects during cardiac catheterization. We report a case of foreign body removal in a patient who had undergone percutaneous coronary intervention (PCI) a month prior at another institution and presented to our cardiac catheterization laboratory with non-ST elevation myocardial infarction.
a severe stenosis in the proximal left anterior descending artery (LAD) was found and treated with a drugeluting stent. In our Emergency Department, the patient noted that he had been having periodic episodes of substernal chest discomfort since the initial stent placement. These episodes were non-exertional and lasted about 5 min. He was compliant with his cardiac medications including aspirin, clopidogrel, metoprolol, and simvastatin. Vital signs and physical examination were unremarkable. His electrocardiogram (ECG) showed diffuse deep T-wave inversions but no Q waves. His troponin was elevated at 5.1 ng/mL.
Division of Cardiology, Jesse Brown Veterans Administration Medical Center and University of Illinois Hospital and Health Sciences System, Chicago, Illinois
CASE REPORT
Conflict of interest: Nothing to report.
In June of 2012, a 76-year-old patient with hypertension, hyperlipidemia, and tobacco abuse presented to our outpatient cardiology clinic for follow-up care. One month prior, he had presented to another hospital with syncope, abdominal pain, and dizziness, and was ultimately diagnosed with an acute coronary syndrome with a peak troponin level of 2.9 ng/mL. At that time,
*Correspondence to: Mladen I. Vidovich; 840 S Wood St, MC 715, Suite 935, Chicago, IL 60612. E-mail: [email protected] Received 6 December 2013; Revision accepted 5 February 2014 DOI: 10.1002/ccd.25427 Published online 8 February 2014 in Wiley Online Library (wileyonlinelibrary.com)
Published 2014. This article is a U.S. Government work and is in the public domain in the USA.
678
Ertel et al.
Fig. 1. A. Coronary angiogram demonstrating circular filling defect (arrow). B. Coronary angiogram demonstrating longitudinal filling defect (arrow).
In view of his presenting symptoms, troponin elevation and recent PCI, we performed urgent coronary angiography. To our surprise, a large filling defect extending proximally from the mid-portion of the LAD stent into the left main coronary artery was appreciated (Fig. 1). At the time of cardiac catheterization, we had no access to the previous angiograms nor the procedure report. Due to the unusual appearance of the filling defect, we performed optical coherence tomography (OCT) (IlumienTM PCI OptimizationTM System with DragonflyTM C7 OCT Imaging Catheter, St. Jude Medical, Minneapolis, MN), which revealed a 3 mm 7 mm tubular structure with adherent thrombus pinned beneath the midportion of a malapposed stent and extending into the left main coronary artery (Fig. 2). This was felt to represent a ‘man-made’ foreign body introduced into the coronary circulation during his previous PCI. Procedural Details
Initial diagnostic angiography was performed through right radial approach with 5 F diagnostic catheters. For OCT imaging we upsized to a 6 F guiding catheter and used a 300 cm coronary wire. For the extraction procedure, we upsized and exchanged to a 7 F guide over the 300 cm coronary wire. The guide was exchanged over the long coronary wire to reliably maintain intracoronary wire position since OCT imaging confirmed the coronary wire was not placed under the recently placed stent struts nor through the foreign body. Through a 4 F multipurpose diagnostic catheter we then inserted the snare (Amplatz GooseNeckV R
Snare Kit, 10 mm loop diameter, 4 F, ev3 Endovascular, Plymouth, MN) and advanced it through the 7 F guide parallel to the coronary guide wire. The snare was placed around the foreign body, stabilized by withdrawing the snare into the 4 F multipurpose catheter and the foreign body was easily retrieved while maintaining the coronary wire position (Fig. 3). The 7 F guide catheter and the coronary wire were left in place. Visual inspection of the foreign body revealed that it consisted of protective plastic tubing that is routinely included in coronary balloon or stent packaging but removed prior to device insertion (Fig. 4). After the retrieval procedure, OCT imaging was repeated and demonstrated a severely malapposed and under-expanded stent with a residual white thrombus ‘cast’ that had formed around the plastic tubing (Fig. 5). Due to the unusual characteristics of the thrombus and stent appearance, we chose not to perform aspiration thrombectomy. We placed a drug-eluting stent in the LAD and then post-dilated the previously placed stent. Final OCT imaging demonstrated optimal stent apposition and expansion. His troponin peaked at 9.8 ng/mL. An echocardiogram performed the day after PCI revealed overall preserved left ventricular function with a small area of hypokinesis isolated to the apex. He was discharged home 2 days later. We subsequently obtained and reviewed the report and the initial procedural angiographic images. At the conclusion of the procedure, the operator did observe “a linear density” and after several additional angiographic projections concluded it was due to an “overlapping vessel”. We hypothesize that the plastic tubing had been
Catheterization and Cardiovascular Interventions DOI 10.1002/ccd. Published on behalf of The Society for Cardiovascular Angiography and Interventions (SCAI).
Coronary Foreign Body Extraction
Fig. 2. A. Optical coherence tomography demonstrating foreign body (white arrow). In the longitudinal view, red arrow demonstrates location of foreign body extending into left main coronary artery across the ostium of left circumflex coronary artery (red asterisk). B. Optical coherence tomography demonstrating
Fig. 3. Share extraction of protective plastic tubing via right radial approach.
introduced at the time of pre-dilation and was likely coronary balloon protective tubing. This is consistent with the location of the foreign body we found - underneath the stent struts and extending proximally into the left main coronary artery. It is similarly plausible that after the introduction of the plastic tubing the lesion had been re-wired to allow placement of the stent.
679
foreign body (large arrow) and malapposed stent struts covering the foreign body (small arrows). In the longitudinal view, red arrow demonstrates location of foreign body in the proximal left anterior descending coronary artery. [Color figure can be viewed in the online issue, which is available at wileyonlinelibrary.com.]
Fig. 4. Removed foreign body attached to snare retrieval device (shown alongside reference plastic tubing from stent used during second PCI). [Color figure can be viewed in the online issue, which is available at wileyonlinelibrary.com.]
DISCUSSION
Intracoronary device loss and foreign body embolization are fortunately rare events. The vast majority of intracoronary foreign bodies are stents that have
Catheterization and Cardiovascular Interventions DOI 10.1002/ccd. Published on behalf of The Society for Cardiovascular Angiography and Interventions (SCAI).
680
Ertel et al.
Fig. 5. Optical coherence tomography demonstrating residual thrombus “cast” after foreign body extraction (white arrow). This appearance is consistent with white thrombus due to its homogeneous backscattering and low signal attenuation [12]. In the longitudinal view, red arrow demonstrates location of residual thrombus in proximal left anterior descending coronary artery. [Color figure can be viewed in the online issue, which is available at wileyonlinelibrary.com.]
become dislodged from their delivery equipment. More rarely, intracoronary balloon, catheter, and guidewire fragments may fracture and embolize into the coronary arteries. In the past, the incidence of device loss was as high as 1–8%; however, in contemporary practice, where stents are no longer mounted by hand in the catheterization laboratory, this has declined to around 0.1% [1–7]. Device loss and foreign body embolization in the coronary circulation are typically recognized at the time of the index procedure and treated promptly. To our knowledge, this is the first case report of disposable protective packaging becoming lodged in the coronary artery during a procedure and left in situ for a prolonged period of time. A number of retrieval techniques for intracoronary foreign bodies have been developed over the years, ranging from open chest surgery to minimally invasive approaches including the loop snare retrieval system that was used in this case [8]. Large studies of outcomes in this patient population are quite limited given the infrequent nature of these events and likely publication bias. While some earlier work suggested an increased complication rate in patients with intracoronary device loss, more recent studies suggest an overall benign post-procedure clinical course [1]. We feel that the use of OCT in this case afforded us the level of diagnostic intracoronary imaging accuracy
to help determine the nature of the filling defect [9]. Given the time course and angiographic appearance, the differential diagnosis of a filling defect included intracoronary thrombus or dissection. The high resolution and characterization of the plastic tubing by OCT substantially contributed to favorable outcome. Additionally, it is quite remarkable that the protective plastic tubing was completely visualized and was translucent to the light emitted by the OCT imaging catheter. We reported this event at the time of the procedure through The Department of Veterans Affairs (VA) and The Food and Drug Administration (FDA) joint Device Surveillance Program [10]. This VA-FDA reporting system is embedded in the VA’s electronic medical record system and provides point-of-care unexpected device problem reporting. Postmarkeing surveillance of medical devices in the United States remains largely a voluntary activity and the system in place at the VA offers a more proactive approach to device surveillance [11]. The ‘long-term fate’ of retained plastic tubing in coronary arteries is unknown; however, the patient’s chest pain coupled with the proximal location of the foreign body suggest that serious complications may have been imminent. Our patient recognized the seriousness of his condition and has supported the publication of his quite unique experience. CONCLUSION
In patients presenting with myocardial infarction after recent PCI and uncertain coronary anatomy with unusual filling defects intracoronary imaging is exceptionally useful to determine the etiology of target lesion failure. While exceedingly uncommon, retained foreign bodies need to be considered as cause of myocardial infarction. ACKNOWLEDGMENTS
Each author participated in the clinical care of this patient. Drs. Ertel and Vidovich were responsible for writing and editing the manuscript. Dr. Shroff was responsible for editing the manuscript. There was no funding source related to this manuscript. We specifically thank our patient who actively encouraged us report this procedure and provided written consent. REFERENCES 1. Brilakis ES, Best PJ, Elesber AA, Barsness GW, Lennon RJ, Holmes DR Jr, Rihal CS, Garratt KN. Incidence, retrieval methods, and outcomes of stent loss during percutaneous coronary
Catheterization and Cardiovascular Interventions DOI 10.1002/ccd. Published on behalf of The Society for Cardiovascular Angiography and Interventions (SCAI).
Coronary Foreign Body Extraction
2.
3.
4.
5.
6.
7.
8.
intervention: a large single-center experience. Catheter Cardiovasc Interv 2005;66:333–340. Cantor WJ, Lazzam C, Cohen EA, Bowman KA, Dolman S, Mackie K, Natarajan MK, Strauss BH. Failed coronary stent deployment. Am Heart J 1998;136:1088–1095. Schatz RA, Baim DS, Leon M, Ellis SG, Goldberg S, Hirshfeld JW, Cleman MW, Cabin HS, Walker C, Stagg J, et al. Clinical experience with the Palmaz-Schatz coronary stent. Initial results of a multicenter study. Circulation 1991;83:148–161. Eggebrecht H, Haude M, von Birgelen C, Oldenburg O, Baumgart D, Herrmann J, Welge D, Bartel T, Dagres N, Erbel R. Nonsurgical retrieval of embolized coronary stents. Catheter Cardiovasc Interv 2000;51:432–440. Alfonso F, Martinez D, Hernandez R, Goicolea J, Segovia J, Fernandez-Ortiz A, Banuelos C, Macaya C. Stent embolization during intracoronary stenting. Am J Cardiol 1996;78:833–835. Elsner M, Peifer A, Kasper W. Intracoronary loss of balloonmounted stents: Successful retrieval with a 2 mm-"Microsnare"device. Cathet Cardiovasc Diagn 1996;39:271–276. Foster-Smith KW, Garratt KN, Higano ST, Holmes DR Jr. Retrieval techniques for managing flexible intracoronary stent misplacement. Cathet Cardiovasc Diagn 1993;30:63–68. Bonvini RF, Rastan A, Sixt S, Noory E, Beschorner U, Leppanen O, Mach F, Schwarzwalder U, Burgelin K, Zeller T.
9.
10.
11.
12.
681
Percutaneous retrieval of intravascular and intracardiac foreign bodies with a dedicated three-dimensional snare: A 3-year single center experience. Catheter Cardiovasc Interv 2009;74:939–945. Guagliumi G, Sirbu V, Musumeci G, Gerber R, Biondi-Zoccai G, Ikejima H, Ladich E, Lortkipanidze N, Matiashvili A, Valsecchi O, et al. Examination of the in vivo mechanisms of late drug-eluting stent thrombosis: Findings from optical coherence tomography and intravascular ultrasound imaging. JACC Cardiovasc Interv 2012;5:12–20. Tsai TT, Box TL, Gethoffer H, Noonan G, Varosy PD, Maddox TM, Fihn SD, Gross TP, Jesse RL, Rumsfeld JS. Feasibility of proactive medical device surveillance: The VA Clinical Assessment Reporting and Tracking (CART) program. Med Care 2013;51:S57–S61. Rumsfeld JS, Peterson ED. Achieving meaningful device surveillance: From reaction to proaction. JAMA 2010;304:2065– 2066. Tearney GJ, Regar E, Akasaka T, Adriaenssens T, Barlis P, Bezerra HG, Bouma B, Bruining N, Cho JM, Chowdhary S, et al. Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies: A report from the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation. J Am Coll Cardiol 2012;59:1058–1072.
Catheterization and Cardiovascular Interventions DOI 10.1002/ccd. Published on behalf of The Society for Cardiovascular Angiography and Interventions (SCAI).
