Prevalence of Subclavian Artery Stent Fractures and their Impact on Restenosis Development

Vértes, Miklós; Hüttl, András Béla; Hüttl, Artúr; Végh, Edit; Nemes, Balázs; Hüttl, Kálmán; Dósa, Edit

doi:10.1016/j.ejvs.2019.06.620

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“…After reviewing the literature, we report the only case of subclavian artery stent fracture leading to coronary subclavian artery steal syndrome and NSTEMI. In a small series published by Miklós & al, the restenosis and reintervention rates were significantly higher in patients with type III-V fractures compared to those with type I-II fractures (60.0% versus 3.6%, P < 0.001; 46.7% versus 3.6%, P < 0.001, respectively) [18].…”

Section: Discussionmentioning

confidence: 88%

An unusual culprit lesion in acute coronary syndrome: In stent-restenosis of a subclavian artery stent

Mamoun¹,

Alessandro²,

Yassine³

et al. 2022

J Clin Images Med Case Rep

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A 73-year old man with past medical history of coronary artery bypass grafting in 2012 and subclavian artery stenting in 2021 was scheduled for an ophthalmologic minor surgery requiring conscious sedation. During the surgery, he developed hemodynamic instability and shortness of breath requiring the conversion to general anesthesia with mechanical ventilation. An electrocardiogram was immediately realized revealing deep negative T waves in all the precordial leads. Elevated troponin level confirmed the diagnosis of non-ST elevation myocardial infarction. Urgent coronary artery angiography revealed a known left coronary system with a chronic Left Anterior Descending (LAD) artery occlusion, a chronic occlusion of the distal circumflex artery and a severe stenosis of left main stem. The right coronary artery presented a significant and calcified stenosis on its mid part. The two venous grafts on the obtuse marginal and the posterolateral artery were both patent. The left subclavian artery could not be crossed to selectively film the left internal mammary artery and an angiogram revealed a tight stenosis in the previous stented segment, limiting the blood flow in the left internal mammary artery. Careful review of the in-stent restenosis suggested neointimal hyperplasia and stent fracture, as detected by stentboost imaging.

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Section: Discussionmentioning

confidence: 88%