A 69 year old man admitted to the hospital due to the chest pain and he diagnosed with inferior MI. In the patient’s history, we learned that right coronary artery (RCA) stent was placed a week ago in another center. He emergently underwent a new coronary angiography for percutaneus coronary intervention (PCI) via right femoral artery sheath. It was detected that the right coronary artery was fully occluded (Figure 1A) and previously deployed RCA stent was malappositioned in the proximal portion of the right coronary artery. While we were trying to cross the lesion, we realised that the tip of floppy guidewire was coiled up and shrinked at the distal portion of the malappositioned stent. Afterwards, we observed that this malappositioned stent was easily coming out as we were cautiously pulling back the guidewire. Therefore, this dislocated stent was immediately removed from coronary artery system and pulled back down to the right femoral artery sheath (figure 1B). Due to the unstabil hemodynamic parameters, new introducer sheath was quickly placed in the left femoral artery to continue PCI. After several RCA stents were properly deployed, damaged coronary area was fully repaired and complete TIMI 3 coronary flow was obtained (Figure 1C-D). Finally, the right femoral artery was surgically explored and the dislocated stent removed via this arteriotomy due to the stent was not completely retrieved back into the right femoral sheath (Figure 2). We here present a very rare PCI complication referring to a malappositioned stent which was totally shrinked and taken out of the coronary system.
