When a Coronary Stent Fails: Can Stentectomy Offer a Way Forward?

A new review suggests that catheter-based removal of a fully deployed coronary stent may be feasible in carefully selected cases of complex stent failure — but only within a highly specialized, imaging-led strategy.

By the Iraq Cardiology Editorial TeamEditorially reviewed by the Iraq Cardiology Review Panel3 min readUpdated August 20, 2026

Original conceptual illustration of a coronary artery with a deployed stent and intravascular imaging guidance for editorial discussion of complex stent failure. — © Iraq Cardiology Community 2026. Original editorial illustration created for this publication; conceptual schematic only, not procedural guidance.

ISCHEMIA

KEY TAKEAWAY A fully deployed coronary stent is usually intended to remain permanent. In selected cases of complex stent failure, however, a new review suggests that planned percutaneous stentectomy may offer a rescue option when continuing harm outweighs the risk of extraction.

Published in Catheterization and Cardiovascular Interventions, the review combines the available literature with five illustrative cases from three academic centres. The cases span acute, subacute, and late presentations of stent failure, framing stentectomy as a structured, case-specific intervention rather than a routine procedure.

WHY INTRAVASCULAR IMAGING MATTERS Intravascular ultrasound is central to the proposed approach. It can help identify suitable anatomy, guide procedural planning, confirm whether extraction is complete, and inform the next step for the treated vessel.

WHAT THIS DOES NOT MEAN This is not evidence that coronary stents have become routinely removable. The report is a narrative review supported by five illustrative cases, not a comparative clinical trial. Potential complications remain substantial and can include arterial injury, stent fragmentation, and embolization.

THE CLINICAL SHIFT The review raises an important concept for complex PCI: when a fully deployed stent itself becomes the continuing source of harm, it may not always be considered untouchable. In carefully selected patients, with intravascular imaging, appropriate equipment, and multidisciplinary Heart Team evaluation, percutaneous stentectomy may become a valuable addition to the complex-PCI rescue toolbox.

EDITORIAL NOTE This feature is intended for professional education and discussion. It does not replace patient-specific assessment, local protocols, or Heart Team decision-making.

SOURCE Martins Filho E, et al. Percutaneous Coronary Stentectomy: Redefining Stent Failure Management in the Modern Era. Catheterization and Cardiovascular Interventions. Published online 13 August 2026.