A rare and late angiographic presentation of DES fracture

The drug-eluting stent (DES) era has seen an increasing number of stent fractures, which is considered one of the mechanisms of restenosis in DES. This increase in recognition could be due to various factors such as increased diagnosis compared to the bare-metal stent era, platform design and strut thickness, higher inflation pressures for DES deployment, and use of DES in more complex lesions (e.g., angulated, diffuse, calcified, bifurcated). The angiographic presentation of DES fracture has been reported as in-stent restenosis (either symptomatic or asymptomatic) in all published cases. We discuss a case of DES fracture presented as an ST-elevation myocardial infarction that was associated with a large coronary artery aneurysm.