title: Acute stent thrombosis due to stent underexpansion managed with rotational atherectomy.
abstract: Stent underexpansion is a well known risk factor for stent thrombosis. We report a case of acute stent thrombosis which occurred after primary percutaneous coronary intervention to the right coronary artery for an inferior ST-elevation myocardial infarction. Minutes after completion of the procedure, the patient had acute stent thrombosis, manifested by new chest pain and new ST-elevation. IVUS showed the stent to be underexpanded. Despite high pressure balloon inflation, the stent remained underexpanded. This was then managed with rotational atherectomy within the underexpanded stent, followed by high-pressure balloon dilatation and deployment of another stent within it.
authors.affiliation: Department of Cardiology, National Heart Centre Singapore, Singapore.
authors.forename: Soumen
authors.initials: S
authors.lastname: Devidutta
authors.affiliation: Department of Cardiology, National Heart Centre Singapore, Singapore. Electronic address: yeo.khung.keong@nhcs.com.sg.
authors.forename: Khung Keong
authors.initials: KK
authors.lastname: Yeo
mesh_terms: D000208:Acute Disease; D017225:Atherectomy, Coronary / Q000379:methods*; D003328:Coronary Thrombosis / Q000601:surgery*; D006083:Graft Occlusion, Vascular / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D015607:Stents; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
keywords: Rotablation; Stentablation