A unique pitfall in percutaneous coronary angioplasty of in-stent restenosis: Guidewire passage out of the stent

Three cases of in-stent restenosis are narrated, wherein, during balloon an gioplasty of the lesion, the guidewire inadvertently exited out of the sten t. The forward balloon progress was halted in this region, In the first cas e, the situation could only be realized when dilatation of a forcefully pus hed small balloon avulsed the well-embedded stent, The mishap was averted i n the subsequent two cases by reintroduction of a new guidewire. Some sugge stions to avoid this eventuality are offered. Though the cases pertain to i n-stent restenosis, the observations may be applicable to the procedures in general that entail passage of a guidewire through a stented area. (C) 200 1 Wiley-Liss, Inc.