title: Acute coronary syndrome due to early multiple and complete fractures in sirolimus-eluting stent: a case report and brief literature review.
abstract: Despite drug eluting stents (DES), as compared to bare metal stents, have reduced in-stent restenosis, complex and long lesions remains a challenge for interventional cardiologist. Their treatment is often associated with an unfavorable outcome, related to in-stent restenosis, stent thrombosis, and target lesion revascularization. These complications may derive from the contact between metallic structures and coronary artery endothelium, and consequent overexpression of platelet activating factors, growth factors, and inflammatory cytokines. Recently, an additional mechanism has emerged as new cause of these complications: "stent fracture." Several factors are involved in this phenomenon including material and stent platform, target vessel features, stent implantation technique, and implant duration. We reported a case of 69 years old man with rare early and complex DES fractures on right coronary that caused acute coronary syndrome 36 hr after a previous percutaneous coronary intervention.
authors.affiliation: Cardiology Unit, S. Elia Hospital, Caltanissetta, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Amico
authors.forename: Salvatore
authors.initials: S
authors.lastname: Geraci
authors.forename: Corrado
authors.initials: C
authors.lastname: Tamburino
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation*; D017023:Coronary Angiography / Q000379:methods; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D020878:Device Removal / Q000379:methods; D054855:Drug-Eluting Stents; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy; D008297:Male; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D011475:Prosthesis Failure; D019233:Retreatment / Q000379:methods; D018570:Risk Assessment; D020123:Sirolimus / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D020123:Sirolimus