The Tale of a Troublesome PDA
Presenter
Jessica Tang, MD, Children's Hospital of Philadelphia, Philadelphia, PA
Jessica Tang, MD, Matthew J. Gillespie, MD, FSCAI and Mudit Gupta, MD, PhD, Children's Hospital of Philadelphia, Philadelphia, PA
Keywords: Complications, Congenital Heart Disease (CHD), Patent Ductus Arteriosus (PDA) and Vascular Access, Management, and Closure
Title:
Stent Embolization During PDA Stent Placement from Carotid Artery Access
Introduction:
Newborn infant with tortuous PDA arising from underside of aortic arch.
Clinical Case:
With advancing a Resolute Onyx coronary stent across the PDA, the guidewire prolapsed out of the PDA and looped in the aortic root. With attempting to retract the stent back out the carotid sheath, the stent then slipped off its balloon and was free-floating in the ascending aorta on the wire. A microsnare was used to snare the superior end of the stent through the carotid artery sheath. With traction on the snare, the stent elongated, became lower in profile, and eventually pulled back into the sheath.
Discussion:
It is safe and feasible to retrieve an embolized stent through carotid artery access. In addition, open-cell stents may be elongated significantly to become lower in profile and easier to retrieve/remove.