This narrative review plus 5 illustrative cases from 3 academic centers evaluated percutaneous coronary stentectomy — intentional retrieval of a fully deployed coronary stent — across acute, subacute, and late settings, covering indications such as malapposition, longitudinal deformation, and excessive aorto-ostial protrusion.
Stentectomy was feasible across all time settings; snare-based retrieval through guide extension catheters was the dominant technique, with stents having ≤3 inter-ring connectors allowing more predictable extraction. Drug-coated balloons enabled metal-free revascularization post-removal, and a novel reverse hairpin-assisted snare technique facilitated pre-TAVR retrieval in one case.
Evidence base is limited to a narrative review plus only 5 cases across 3 centers, with no systematic comparison of outcomes or controls. Case selection bias and lack of long-term follow-up data are inherent to this design.
When a deployed coronary stent causes ongoing complications (malapposition, thrombosis, aorto-ostial protrusion, or interference with structural interventions), percutaneous stentectomy — guided by intravascular ultrasound and Heart Team evaluation — is a viable structured strategy. Stents with ≤3 inter-ring connectors are more amenable to extraction; drug-coated balloons can provide metal-free revascularization after removal.
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