NEW YORK (Reuters Health), Aug 14 - The findings from a small study suggest that coronary stent loss from its delivery balloon is a rare complication, but it can lead to significant adverse events.
As they report in the American Journal of Cardiology for August 1, Dr. Juergen Kammler and colleagues from General Hospital Linz in Austria assessed the occurrence of coronary stent loss in 7,139 stent implantation procedures performed at their hospital between 1995 and 2004.
Thirty-six cases (0.5%) of stent loss were identified, the report indicates.
Complete stent retrieval with no complications occurred in just four cases. In another case, the stent was also completely removed, but not until it had embolized and become lodged in the femoral artery, necessitating arteriotomy.
In 26 cases, the stent was retrieved from the coronary circulation, but after removal a peripheral embolism formed at another vascular site. One of these patients died during the hospital stay from unrelated causes. Follow-up evaluation was available for 20 of the 25 remaining patients and indicated no long-term stent-related ischemic symptoms.
In five cases, the stent could not even be retrieved from the coronary circulation. One of the patients died from 24 hours later from MI-related heart failure, while two additional patients required CABG to open blockages related to the lost stent. The remaining two patients have experienced no significant complications.
CT evaluation successfully detected the lost stent in 15 of 20 patients. In most cases, the stent was found in the profunda branch of the femoral artery. Nonvisualization of the lost stent was invariably due to the presence of arteriosclerosis with extensive calcification.
"If stents cannot be retrieved from the coronary system, severe problems may occur," the investigators note. "Stent loss with peripheral embolization is asymptomatic in long-term follow-up."
Last Updated: 2006-08-11 16:36:12 -0400 (Reuters Health)
Am J Cardiol 2006;98:367-369.
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