Unstable Angina Induced by Fracture of a Recently Implanted Drug-Eluting Stent

Stent fracture is a rather infrequent complication associated with in-stent restenosis, thrombosis, aneurysm formation, and ischemic events. Several stent-related parameters, such as the use of longer or multiple stents, stent overlapping, and balloon/stent overexpansion are potential predictors of stent fracture. Stents deployed in right coronary artery lesions with exaggerated motion, tortuosity, or severe calcification are also generally considered to be at higher risk for fracture. This case demonstrates that intravascular ultrasound imaging is extremely useful to confirm the diagnosis and identify the possible mechanism of the stent fracture, as well as to assess the final result after subsequent angioplasty.