Sent-Induced Coronary Stenosis in a Previously Noncritical Segment Following PCI: A Case Report

While percutaneous coronary interventions (PCI) with stenting are standard in treating coronary artery disease, rare complications such as stent-induced de novo stenosis can paradoxically provoke acute coronary syndromes (ACS). We present the case of a 48-year-old female (Middle Eastern descent) with a recent history of coronary angioplasty, who presented with ACS 2 months post-procedure. Coronary angiography revealed critical stenosis in the left main (LM), a previously noncritical segment. Additionally, there was significant in-stent restenosis in the previously deployed stents in the left anterior descending (LAD) and left circumflex (LCX) arteries. This recurrent scenario of stenosis development in non-stented regions following stent placement suggests the need to explore underlying hypersensitivity reactions as one of several possible mechanisms. Further investigation into the mechanisms, whether immunological or atherosclerotic, is warranted.