Male in his 70s underwent emergent PCI for STEMI in LAD. This time, he underwent staged PCI for LCX#13 90% stenosis. Contrast leakage was observed at the start of Stent deploy after pre-dilation, and balloon rupture was suspected. We attempted to retrieve the stent, but both ends were partially dilated and the stent could not be retrieved into the guide even with a guide extension catheter. The stent balloon shaft was torn when attempting to retract it. 

Coronary Angiography :  The right coronary artery (RCA) had  a occulusion in AV branch, and the left anterior descending coronary artery was already treated, and the left circumflex artery had a 90% stenosis in the mid to distal vessel.

First, a 2nd wire was used to pass through the strut of the stent, and the entire system was retrieved to the brachial artery with the guiding catheter and stent locked using a 2.0/40 mm balloon.After the 2nd wire, balloon, and guiding catheter were removed, a torn shaft appeared from the sheath inserted into the right radial artery, which was manually removed. We sized up the sheath from a 6Fr to a 7Fr glide and inserted a 5Fr sheath with the tip in the shape of a flare. Finally, a 1.5mm balloon is inserted and inflated into the stent while holding the upper arm externally. The stent was successfully retracted and stored in the 7Fr sheath while holding the 5Fr sheath against the stent.

Contrast leakage was observed, balloon rupture was suspected, and an attempt was made to retrieve the stent, but the stent balloon shaft was torn after being pulled. We were able to bail out by calmly handling the situation.