Circ Cardiovasc Interv

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Circ Cardiovasc Interv MRI-Induced Stent Dislodgment Soon After Left Main Coronary Artery Stenting by Harikrishnan Parthasarathy, Omar Saeed, Danny Marcuzzi, and Asim N. Cheema Circ Cardiovasc Interv Volume 6(5):e58-e59 October 15, 2013 Copyright © American Heart Association, Inc. All rights reserved.

Baseline coronary angiography. Baseline coronary angiography. Baseline coronary angiography showing a significant and eccentric left main coronary artery (LMCA) stenosis (A) that was managed by surgical revascularization. Right coronary artery showed no significant plaque (B). Arrowhead indicates stenosis in the LMCA. Harikrishnan Parthasarathy et al. Circ Cardiovasc Interv. 2013;6:e58-e59 Copyright © American Heart Association, Inc. All rights reserved.

Repeat coronary angiography with intravascular ultrasound of the left main coronary artery. Repeat coronary angiography with intravascular ultrasound of the left main coronary artery. Repeat coronary angiography 12 months after coronary artery bypass graft surgery showed previously known stenosis of left main coronary artery (LMCA; arrowhead), nonobstructive disease of left anterior descending artery and circumflex (A), minor plaque of the right coronary artery (B), patent vein graft to obtuse marginal branch (C), and occluded left internal mammary artery graft (D). Intravascular ultrasound of LMCA (E) confirmed an eccentric plaque with significant stenosis (minimal lumen diameter, 2.5 mm; minimal lumen area, 5.1 mm2). C indicates intravascular ultrasound catheter; line with 2 arrowheads, minimal lumen diameter; and P, eccentric plaque. Harikrishnan Parthasarathy et al. Circ Cardiovasc Interv. 2013;6:e58-e59 Copyright © American Heart Association, Inc. All rights reserved.

Follow-up coronary angiography with stenting of the left main coronary artery under intravascular guidance. Follow-up coronary angiography with stenting of the left main coronary artery under intravascular guidance. PCI of the left main coronary artery (LMCA) with drug-eluting stent that was postdilated with a noncompliant balloon with excellent angiographic result (A–E). Intravascular ultrasound (IVUS) images showed appropriate stent sizing, adequate and symmetrical expansion (F), and stent struts extending proximal to the ostium of LMCA in cross-sectional (G) and longitudinal views (H). Arrowheads indicate stent struts extending proximal to the ostium of LMCA; C, IVUS catheter; PCI, percutaneous coronary intervention; and S, stent struts. *Well-expanded stent struts with good apposition to the vessel wall (minimal lumen diameter, 4 mm). Harikrishnan Parthasarathy et al. Circ Cardiovasc Interv. 2013;6:e58-e59 Copyright © American Heart Association, Inc. All rights reserved.

Follow-up coronary angiogram after MRI Follow-up coronary angiogram after MRI. Follow-up coronary angiogram showed absence of previously implanted stent (A) and an intermediate residual stenosis in the left main coronary artery (B). Follow-up coronary angiogram after MRI. Follow-up coronary angiogram showed absence of previously implanted stent (A) and an intermediate residual stenosis in the left main coronary artery (B). Arrowheads indicate previously stented segment. Harikrishnan Parthasarathy et al. Circ Cardiovasc Interv. 2013;6:e58-e59 Copyright © American Heart Association, Inc. All rights reserved.

Noncontrast computed tomography of abdomen and pelvis showing dislodged stent. Noncontrast computed tomography of abdomen and pelvis showing dislodged stent. A whole-body noncontrast computed tomography identified the dislodged stent in the proximal part of left internal iliac artery (arrowheads). The stent location is shown in transverse (A), coronal (B and C), and sagittal planes (D). Harikrishnan Parthasarathy et al. Circ Cardiovasc Interv. 2013;6:e58-e59 Copyright © American Heart Association, Inc. All rights reserved.