title: A completely fractured zotarolimus-eluting stent in an aortocoronary saphenous vein bypass graft.
abstract: Drug-eluting stents (DES) have significantly improved the rate of target vessel revascularization in comparison with bare metal stents. DES fracture was not reported in multicenter randomized clinical trials, but several case reports of DES fracture have been published, mostly with sirolimus-eluting stents. DES fracture is associated with stent restenosis and thrombosis. We report a zotarolimus-eluting stent fracture in an aortocoronary saphenous vein graft (SVG) bypass. The patient presented with chest pain and a non-ST-elevation myocardial infarction. He underwent cardiac catheterization that showed a complete fracture of a zotarolimus-eluting stent in the ostium of a sequential SVG to the diagonal and obtuse coronary arteries. His management included coronary angioplasty and retrieval of the proximal fractured segment. We discuss the potential causes for this stent fracture and suggest caution when using a DES in an ostial location of a SVG bypass, especially in a highly mobile vessel.
authors.affiliation: Section of Interventional Cardiology, Division of Cardiology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: Carmelo V
authors.initials: CV
authors.lastname: Venero
authors.forename: Venkata R
authors.initials: VR
authors.lastname: Aligeti
authors.forename: Dale C
authors.initials: DC
authors.lastname: Wortham
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D017023:Coronary Angiography / Q000379:methods; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000379:methods; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000628:therapy; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D054855:Drug-Eluting Stents; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D011475:Prosthesis Failure; D019233:Retreatment; D018570:Risk Assessment; D012501:Saphenous Vein / Q000637:transplantation; D012720:Severity of Illness Index; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives; D016896:Treatment Outcome
chemical_list: C489443:zotarolimus; D020123:Sirolimus