PCI of the right coronary artery via or under struts of stents protruding into the aorta

Reported are two cases in which stent protrusion from the right coronary ostium into the aorta caused considerable difficulty in interventions. Two different methods were applied to overcome this problem. In the first (elective) case a new orifice was created at the side of the protruding stent. In the second case (acute inferoposterior and right myocardial infarction associated with complete heart block, recurrent ventricular fibrillation and shock), a new track was created underneath the underexpanded protruding stent, and the protruding stent was crushed under a new stent. Stents protruding from the right coronary artery into the aorta may present a considerable challenge during interventions, which can be managed by certain technical modifications.