A Challenging Case of Stent Dislodgement During Percutaneous Coronary Intervention Complicated by Peripheral Embolization

We report a challenging case of stent dislodgement for a 49-year-old male with a history of end-stage renal disease and insulin-dependent diabetes undergoing an elective coronary angiogram for cardiac risk stratification before kidney transplant surgery. A diagnostic transradial coronary angiogram was performed showing two severe type A lesions to the proximal and distal left circumflex artery (LCx). While attempting to stent the proximal LCx, the stent dislodged to the left main coronary artery (LMCA). The stent was successfully retrieved from the LMCA via the transradial route using the small balloon anchoring technique. Unfortunately, while attempting to retrieve the stent-balloon assembly, the stent was accidentally stripped off the balloon embolizing to the right superior gluteal artery. Given the stable location, no attempt was made to retrieve the stent and the patient had no complications on follow-up. This case highlights the challenges in managing coronary stent loss including risk factors for stent dislodgement, methods to retrieve the stent, and the risk of stent embolization.