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Updated: May 18, 2026
Imaging In-Stent Restenosis: An Inexpensive, Reliable, and Rapid Preclinical Model
Published on: September 14, 2009
Very late stent thrombosis complicating a previously lost and partially crushed stent: demonstration by optical
Rocco A Montone1, Leonardo Cataneo, Silvia Minelli
1Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
Insights
Stent thrombosis can occur years after a lost stent fragment causes complications. Optical coherence tomography guided treatment for this rare very late stent thrombosis case.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Medical Device Technology
Background:
- Stent thrombosis (ST) is a severe complication following coronary stenting.
- Factors contributing to ST include procedural issues and patient-related elements.
- Increased stent material, such as overlapping stents in complex bifurcations, correlates with higher ST rates.
Observation:
- A case of very late stent thrombosis (VLST) was observed.
- The thrombosis occurred on a stent that was previously lost within the coronary circulation.
- The lost stent was partially crushed, suggesting incomplete deployment.
Findings:
- Optical coherence tomography (OCT) was utilized for procedural guidance.
- OCT imaging allowed for detailed visualization of the partially crushed, lost stent.
- The findings highlight a potential substrate for VLST: incompletely deployed, lost stent material.
Implications:
- This case underscores the potential long-term risks associated with lost or incompletely deployed coronary stents.
- OCT guidance may be crucial in managing complex cases involving maldeployed or lost stent fragments.
- Understanding these rare mechanisms is vital for improving patient outcomes in interventional cardiology.
Abstract:
Stent thrombosis (ST) is the most dramatic complication of coronary stenting. Mechanisms of ST are multiple, including procedural and patient-related factors. A considerable burden of metal inside the coronary has been associated with ST as suggested by the higher rate of ST in case of multiple overlapping or complex two stents procedure in bifurcation lesions. However, occasional stent loss and failure to retrieve it may be a substrate of ST, especially if multiple layers of stent struts are incompletely crushed. Here, we describe a case of very late ST on a partially crushed stent previously lost inside the coronary circulation, using optical coherence tomography (OCT) for guidance during the procedure.
