Coronary stent dislodgment after deployment during bifurcation treatment with the double kissing crush technique: A case report

A 50-year-old male was admitted to our institution because of an acute pulmonary edema successfully treated with diuretics. His cardiovascular risk factors include smoking habit and type 2 diabetes mellitus. Since the ECG showed a sinus rhythm 78 bpm and negative T waves in DI and aVL and the echocardiogram showed hypokinesia of the apex and of mid-distal anterior wall of the left ventricle with mild to moderate systolic dysfunction, the patient was scheduled for an elective coronary angiography. The coronary angiography revealed a critical stenosis of the medium left anterior descending (LAD) involving the origin of the 2nd diagonal branch (D2) (Medina 1,1,1). During the planned strategy for the bifurcation treatment according to the double kissing crush technique, we observed a dislodgement of the fully deployed stent in D2. We treat this unusual complication with an additional stent and we conclude the PCI with a good angiographic result. We discuss this very unusual complication and we compared it with other similar cases.