Coronary artery stent fracture with in-stent restenosis and aneurysm formation: Diagnosis and successful treatment with graft stent implantation

Štambuk, Krešimir; Pavlović, Nikola; Gabrić, Ivo Darko; Krčmar, Tomislav; Trbušić, Matijas; Manola, Šime

doi:10.1016/j.ijcard.2010.04.087

Cited by 3 publications

(2 citation statements)

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“…This suggests that a different mechanism may affect the ISR in the fractured SES compared to that in the BMS. Previous studies have reported a higher frequency of ISR associated with SF, ranging from 6.3% to 60.0%, [8][9][10][11][12]14,16,17 and stent thrombosis, 12,23 my-ocardial infarction, 24,25 coronary aneurysm, [26][27][28] and sudden death 29 are also reported as a complications associated with SF. There are various strategies for treatment of ISR associated with SF, including simple redilation with a balloon or cutting balloon, and repeat DES deployment (same or another type); however, no optimal strategy has been established.…”

Section: Discussionmentioning

confidence: 99%

Late Catch-Up Phenomenon Associated with Stent Fracture after Sirolimus-Eluting Stent Implantation: Incidence and Outcome

Serikawa

Kawasaki

Koga

et al. 2010

Journal of Interventional Cardiology

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Section: Discussionmentioning

confidence: 99%

Late Catch-Up Phenomenon Associated with Stent Fracture after Sirolimus-Eluting Stent Implantation: Incidence and Outcome

Serikawa

Kawasaki

Koga

et al. 2010

Journal of Interventional Cardiology

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“…There are only 20 available English-language case reports on CAA with SF [3][4][5][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40] (Table). In these case reports, the patient ages ranged from 7 to 73 years (mean, 59.9 years), and 15 males and 4 females were included; there was one case where the patient's age and gender were not specified.…”

Section: Discussionmentioning

confidence: 99%

Coronary Artery Aneurysm Caused by a Stent Fracture

et al. 2018

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SummaryCoronary stent fracture (SF) is rare as a complication of percutaneous coronary intervention (PCI), and its adverse events are increasingly being recognized with the development in devices of PCI. The major adverse events caused by SFs are in-stent restenosis due to neointimal overgrowth caused by poor drug delivery.1,2) A coronary artery aneurysm (CAA) is a rare complication of SF, but may lead to lethal events such as acute coronary syndrome or rupture of the CAA further leading to cardiac tamponade. [3][4][5] However, the management of CAAs is controversial with or without SF.6) Herein, we report a case of a CAA caused by an SF and discuss the management of CAA complicated with SF, along with a literature review. We suggest that surgical treatment should be considered the higher-priority strategy in the cases of CAA with SF as compared to CAA without SF.(Int Heart J 2018; 59: 203-208) Key words: Coronary artery disease, Drug-eluting stent, In-stent restenosis A lthough the use of drug-eluting stents (DESs) has significantly improved its long-term outcomes after percutaneous coronary intervention (PCI), instent restenosis (ISR) still occurs in some cases and target vascular revascularization is required. 7,8) Coronary stent fracture (SF) is increasingly being recognized as one of the causes of ISR.1) SF can be classified into several types, and complete and severe fracture types rarely lead to coronary artery aneurysm (CAA).9,10) Thus far, the established treatment and management for CAAs with SF are unclear. Case ReportA 69-year-old man with multiple coronary risk factors, including hypertension, hyperlipidemia, type-2 diabetes mellitus, smoking history, and chronic kidney disease, presented to our hospital for a follow-up coronary angiography (CAG) 6 months after PCI. He had undergone CAG and PCI several times as described below.In 2003, an electrocardiogram showed ST segment depression, and a cardiac exercise stress test and radioisotope revealed ischemic changes in the anterior and inferior segments of the left ventricle; therefore, CAG was performed for the first time. CAG demonstrated 90% stenosis in the proximal right coronary artery (RCA) and 75% stenosis in the proximal left anterior descending artery (LAD) with mild stenosis in the left circumflex artery (LCX). PCI was successfully performed, and bare-metal stents (BMSs; 4.0 × 13 mm and 3.5 × 20 mm) were implanted in the ostium of the RCA and proximal LAD, respectively. Six months later, in 2004, a follow-up CAG revealed no in-stent restenosis (ISR), and dual antiplatelet therapy (DAPT) was changed to single antiplatelet therapy (SAPT). In 2014, the patient was diagnosed with earlystage gastric cancer, and CAG was performed before the gastric cancer surgery. CAG revealed ISR in the RCA and progression of the stenosis in the LCX. A week before the surgery, SAPT was changed to heparin, and DAPT was started after it. Following the surgery, PCI was performed and a zotarolimus-eluting stent (Resolute Integlity 2.5 × 22 mm) was implanted in the LCX,...

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