Unintentional extraction of a coronary stent deployed 4 months earlier during cutting-balloon angioplasty for in-stent restenosis.

In general, coronary stents, when deployed in a coronary artery by conventional balloon expansion, appear to be tightly forced into the vessel wall, virtually precluding intentional or unintentional removal of the stents. Here, we present a case of unintended coronary stent extraction during cutting balloon angioplasty for high-grade in-stent restenosis of a stent successfully deployed 4 months earlier. The blades of the cutting balloon became stuck in the stent struts. Retrieval of the cutting balloon was only possible in conjunction with the stent using increased traction. Subsequent vessel closure was recanalized and a paclitaxel-eluting stent was implanted, covering the entire region of the previous stent and rendering an excellent angiographic result. Careful inspection of the extracted stent demonstrated complete removal. Retrospective analysis of the stent implantation procedure 4 months prior revealed complete stent expansion and closely matched stent and vessel dimensions as assessed by angiographic criteria.