Acute ST-Elevation Myocardial Infarction after Coronary Stent Fracture

Abstract

The invention of the drug-eluting stent (DES) has brought about revolutionary changes in the field of interventional cardiology. In the DES era, in-stent restenosis has declined but new issues such as stent thrombosis have emerged. One of the emerging paradigms in the DES era is stent fracture. There are reports about stent fracture leading to in-stent restenosis or stent thrombosis. Most of these reports concern the Sirolimus-eluting stent. The present case is a representation of a Biolimus-eluting stent fracture. We introduce a 64-year-old male patient, for whom the BioMatrix stent was deployed in the right coronary artery. Five months after the implantation, he experienced acute myocardial infarction, with stent fracture leading to stent thrombosis being the causative mechanism. Another DES (Cypher) was used to manage this situation, and the final result was good.

Keywords: Drug-eluting stents; Myocardial infarction; Stents; Treatment failure.

Figure 1

Total occlusion of right coronary artery in right anterior oblique view of coronary angiography (arrow)

Figure 2

Stent enhancement clearly shows stent fracture (arrow) in right anterior oblique view of coronary angiography

Figure 3

Finally, right anterior oblique angiography showed that there was no evidence of residual stenosis after stent deployment.