SURGICAL REMOVAL OF A DISLODGED PERIPHERAL STENT DURING PERCUTANEOUS INTERVENTION FOR A LEFT SUBCLAVIAN ARTERY LESION

Le résumé fourni par la source

Subclavian artery stenosis is an uncommon atherosclerotic condition that may lead to upper limb ischemia, subclavian steal, or coronary–subclavian steal syndrome. Although endovascular therapy is the preferred treatment, procedure-related complications may occasionally arise. This report describes a rare and technically challenging case of stent dislodgement during intervention for severe proximal left subclavian artery stenosis in a 69-year-old man presenting with arm pain and a significant inter-arm blood pressure gradient. Imaging revealed severe stenosis, and a combined coronary artery bypass grafting (CABG) and subclavian stenting was planned. During the procedure, the balloon-mounted stent became dislodged while being withdrawn through an angulated and calcified segment and migrated to the right femoral artery. Multiple percutaneous retrieval attempts, including balloon-assisted trapping and snare techniques, were unsuccessful due to firm embedding of the stent. It was ultimately removed surgically from the proximal right profunda femoris artery through a minimal-access approach under sedation. This case highlights that stent dislodgement, although rare, remains a serious complication that may require immediate surgical intervention when endovascular retrieval fails. Adequate lesion preparation, proper catheter support, and performing complex procedures in centers with surgical backup are essential to mitigation and safe management.

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