Skip Navigation


European Heart Journal Advance Access originally published online on May 4, 2007
European Heart Journal 2007 28(19):2325; doi:10.1093/eurheartj/ehm137
This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
28/19/2325    most recent
ehm137v1
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Fineschi, M.
Right arrow Articles by Pierli, C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Fineschi, M.
Right arrow Articles by Pierli, C.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Multiple sirolimus eluting stent fractures

Massimo Fineschi*, Arcangelo Carrera, Tommaso Gori and Carlo Pierli

U.O. Emodinamica, Azienda Ospedaliera Universitaria Senese, Viale Bracci, Siena 53100, Italy

* Corresponding author. Tel: +39 0577585719; fax: +39 0577586198. E-mail address: orfine{at}tin.it

A 73-year-old woman was admitted with a history of previous myocardial infarction and a nuclear perfusion scan showed an area of ischaemia in the inferior wall. Coronary angiography revealed a total occlusion of the proximal right coronary artery (RCA); percutaneous coronary intervention was performed and two sirolimus eluting stents (Cypher 3.0–33 mm, Cypher 3.0–28 mm, and Cordis) were deployed (in overlapping) at 16 atm with a good angiographic result. No gap between the two stents (Panel A) was evident at fluoroscopic images. The full metal jacket distended the normal tortuosity of the vessel.

Twenty-eight months later, the patient returned to our emergency department for unstable angina.

Repeat angiography showed the patency of the vessel with multiple sites of angiographically non-significant in-stent neointimal proliferation; the fluoroscopic images revealed complete stent fracture and misalignment located in the proximal (moderate angulation) and middle segments (site of overlapping and hinge points) of the RCA (Panel B, arrows). The vessel had regained its physiological tortuosity.

Intravascular ultrasonography (Galaxy, Boston Scientific) confirmed the absence of metallic struts in the site of circumferential fracture with neointimal hyperplasia at the strut-free segments (Panels C–F).

Vessel tortuosity and the use of overlapping stents may contribute to these complications.

Formula


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?



This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
28/19/2325    most recent
ehm137v1
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Fineschi, M.
Right arrow Articles by Pierli, C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Fineschi, M.
Right arrow Articles by Pierli, C.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?