Peripheral embolisation and retrieval of an everolimus-eluting stent during intervention in a tortuous right coronary artery

A 78 year-old female with dyslipidemia, diabetes, and hypertension as cardiovascular risk factors underwent percutaneous coronary intervention of tortuous, diffusely diseased right coronary artery (90% stenosis) due to chronic stable angina (Canadian Cardiovascular Society class III) despite guideline-directed medical treatment. After predilatation, a 2.75 × 44 mm Xience Expedition everolimus-eluting stent (Abbott, USA) was tracked, which failed and embolised to the right deep femoral artery during its pullback. It was successfully retrieved by an EN snare: 6–10 mm (Merit Medical, USA) by contralateral femoral approach. Lesion was further dilated and successfully stented using a GuideLiner mother–and-child catheter (Vascular Solutions Inc., USA) by deploying two overlapping 2.75 × 33, and 3 × 23 Xience Expedition drug-eluting stents distally and proximally respectively showing proper stent expansion with TIMI-3 coronary flow.This case highlights trackability issues and the importance of adequate lesion preparation before stent deployment in a tortuous vessel with diffuse disease, especially with a very long stent.