Because of persistent stenosis in the obtuse marginal was previously dilated physician attempted to pass a 2.25 x 12 mm synergy drug-eluting stent into the obtuse marginal to overlap with the previously placed stent.There was considerable difficulty despite guide and guide liner support.Several different configurations of wire and guide liner support were attempted to deliver the stent.The stent was being removed and there was considerable difficulty to return the stent delivery system into the guide.When the stent delivery was removed there was evidence of loss of stent.On fluoroscopy the undeployed stent was in the proximal circumflex.During removal of the stent delivery there was inadvertent removal of the wire from the circumflex and the undeployed stent.The physician initially attempted to wire into the circumflex with a plan of stenting the undeployed stent against the wall.Several wires were attempted unsuccessfully.It would not traverse the proximal vessel because of the tortuosity and now the undeployed stent reflecting the wire tip.When we rotated views to help with facilitation of wire passage it became obvious that the proximal portion of the stent had recoiled into the lad.This meant the stent was laying perpendicular to the left main with a portion in the lad and the majority in the proximal circumflex.Given this complex configuration it was obvious the stent would not be able to be rewired or removed with a retrieval device.The options of bifurcational left main stenting or single stenting of the lad into the left main were considered but given this patient's known occlusion of the rca vessel placement in increased risk of adverse events.The physician elected at that time to discontinue the intervention to discuss the options with thoracic surgery.
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