Coronary artery stent fracture with aneurysm formation and in-stent restenosis

Coronary stent fracture is a relatively rare but potentially serious complication of coronary artery stenting. It has been recognised as a cause of in-stent restenosis as well as acute stent thrombosis. Most fractures occur in stents after aggressive post-dilatation, stents implanted in tortuous and calcified lesions, and after cardiac trauma [M.S. Lee, D. Jurewitz, J. Aragon, J. Forrester, R.R. Makkar, S. Kar Stent fracture associated with drug-eluting stents: clinical characteristics and implications. Catheter Cardiovasc Interv. Feb 15 2007;69(3):387–394.,Makaryus AN, Lefkowitz L, Lee AD, Coronary artery stent fracture. Int J Cardiovasc Imaging. Jun 2007;23(3):305–309. Electronic publication 2006 Sep 28.,E.S. Brilakis, C. Maniu, M. Wahl, G. Barsness (2004) Unstable angina due to stent fracture J Invasive Cardiol 16(9):545.,G. Sianos, S. HOfma, J.M. Ligthart et al. Stent fracture and restenosis in the drug eluting stent era. Catheter cardiovasc Interv 2004; 61(1):111–116.]. We report on a case of delayed stent fracture that gradually lead to in-stent restenosis (distal part), significant fragment displacement with the formation of a coronary artery aneurysm that was unsuitable for percutaneous intervention.