Role of intravascular ultrasound in the management of intracoronary dislodged stent

We describe a nonagenarian patient in whom a paclitaxel-eluting stent was lost during an attempt of direct stent implantation at the distal right coronary artery after removal of the guide-wire. The potential usefulness of intravascular ultrasound in the management of this complication is illustrated. The dislodged stent could not be located by fluoroscopy. However, intravascular ultrasound allowed to find the undeployed stent at the proximal segment of the right coronary artery. It showed that the guide-wire was placed outside the lost stent lumen and this undeployed stent was crushed against a previously implanted stent by another stent with optimal intravascular ultrasound-guided implantation.