Acute coronary syndrome due to hinge movement of a bare-metal stent

Recently, attention has been given to stent fracture (SF) as a risk factor of in-stent restenosis. SF is sometimes revealed at the site of hinge movement (HM). HM synchronized to heart beats might cause chronic mechanical stress of the vessel wall, resulting in chronic inflammation and mobilization of inflammatory cells, and this might lead to formation of atheromatous plaque. A 59-year-old man in whom a bare metal stent (BMS) had been deployed to the right coronary artery 9 years ago visited our clinic due to acute coronary syndrome (ACS). Emergency coronary angiography revealed HM at the site of the BMS where thrombotic occlusion was revealed. ACS might be caused by chronic mechanical stress due to HM of the BMS.