Article Details

Stent deformation can occur during percutaneous coronary intervention (PCI). One of the mechanisms is unrecognized abluminal wiring followed by balloon dilatation. Management options for stent deformation in this scenario include crushing the stent or rewiring the stent lumen, but the latter approach can be challenging. This report describes a case of stent deformation successfully managed by rewiring the true stent lumen using the real-time intravascular ultrasound (IVUS) tip-detection wiring technique. A 66-year-old man was admitted for anterior ST-segment elevation myocardial infarction and underwent primary PCI, which revealed acute thrombotic occlusion of the left anterior descending artery (LAD). The wire was accidentally retracted after stent deployment. After rewiring, the stent was post-dilated with non-compliant balloon. However, IVUS revealed deformation of the proximal stent edge due to abluminal wiring. Rewiring of the stent lumen was successful using the real-time IVUS tip-detection technique. The deformed stent was successfully restored.

Keywords: Stent deformation; IVUS; IVUS tip-detection; Real-time wiring