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A patient with recurrent failure of a saphenous vein graft to the first obtuse marginal branch was referred for recanalization of the native circumflex CTO. Antegrade wiring failed due to proximal cap ambiguity. Retrograde crossing was successful using a Venture catheter for retrograde wiring via the SVG and the reverse CART technique. After wire externalization and predilation, two DES were placed in the CTO restoring antegrade flow to OM1. The SVG was occluded with an Amplatzer vascular plug II. We decided to place one more DES distal to the prior stents, but stent delivery failed and during retrieval the stent came off the balloon in the proximal circumflex. The small balloon technique failed to retrieve the stent. We advanced a second guidewire and crushed the lost stent, followed by successful delivery and deployment of another DES. The crushed stent migrated distally in the OM1. We used a 2-4 mm Ensnare to retrieve it but there was significant resistance to withdrawal attempts. Coronary angiography showed a large vessel perforation likely due to stent retrieval attempts. A PK Papyrus covered stent was deployed successfully sealing the perforation and also covering the lost DES and preventing further migration.