Stent thrombosis following the STAR technique in a complex RCA chronic total occlusion.
Four drug-eluting stents were deployed in the right coronary artery (RCA) of a symptomatic young woman who presented with a chronic total occlusion (CTO) of the RCA. The occlusion was successfully crossed using the recently described STAR technique. However, the patient died suddenly 15 hr later. Autopsy demonstrated a long segment of subintimal stenting in the proximal and mid RCA that was intraluminal in the distal vessel. Acute stent thrombosis in the subintimal stents was responsible for sudden death. This case highlights the potential risk of performing extensive subintimal stenting for CTO.
Erlich
Ilana
I
The Roy and Ann Foss Cardiovascular Research Program, Terrence Donnelly Heart Center, St. Michael's Hospital, Toronto, Ontario, Canada.
Strauss
Bradley H
BH
Butany
Jagdish
J
D015906:Angioplasty, Balloon, Coronary; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D002317:Cardiovascular Agents / Q000627:therapeutic use; D002908:Chronic Disease; D020099:Coated Materials, Biocompatible / Q000627:therapeutic use; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008875:Middle Aged; D020123:Sirolimus / Q000627:therapeutic use; D015607:Stents / Q000009:adverse effects*; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology
D002317:Cardiovascular Agents; D020099:Coated Materials, Biocompatible; D020123:Sirolimus