Stent Crumpling as a Complication of Percutaneous Coronary Intervention, a Case Report and Literature Review

Abstract

Stent crumpling is a rare but potentially life-threatening complication of percutaneous coronary intervention (PCI). This report highlights a case of stent crumpling during a PCI procedure, its management, and the importance of advanced imaging techniques in diagnosing and addressing such complications. A 78-year-old man was admitted for elective PCI on the left anterior descending (LAD) artery following an acute anterior ST-segment elevation myocardial infarction (STEMI) treated with thrombolytic therapy. The patient exhibited significant ischemic changes on his electrocardiogram (ECG) and experienced persistent angina. During the PCI, two overlapping stents were deployed in the LAD. Post-dilation led to slow flow and thrombus formation in the LAD, rapidly progressing to cardiac arrest. Immediate resuscitation and intracoronary thrombolytic therapy were initiated. Intravascular ultrasound (IVUS) revealed stent crumpling, so the proximal stent folded within the vessel lumen. To solve this issue, the crumpled stent was crushed behind a newly deployed stent, followed by post-dilation, which restored TIMI flow grade III in the LAD.