An Undersized Stent Does Not Forgive

Konstantinos Triantafyllou, Dimitrios Oikonomou, Dimitra Benia, Antigoni Kyparissi, Georgios Ferentinos, Dimitrios Stalikas, Konstantinos Kappos


Stent thrombosis is a rare complication of percutaneous coronary intervention (PCI) with potential devastating results. Stent undersizing and malapposition are major risk factors of stent thrombosis and have been strongly associated with early stent thrombosis. However, despite the continuous progress of interventional cardiology, there is no consensus regarding optimal management of this medical emergency. Herein, we present a case of subacute stent thrombosis that manifested as a severe inferior ST-elevation myocardial infarction four days after an initial PCI of the right coronary artery. A stepwise treatment approach was followed aiming initially to achieve flow TIMI III without stenting during primary PCI. During a revision procedure, stent undersizing and malapposition were identified as underlying mechanisms of stent thrombosis using intravascular imaging guidance and treated successfully with corrective PCI. Further evidence is needed to refine the optimal treatment strategy in the setting of stent thrombosis. Rhythmos 2019;14(2):31-34.



drug-eluting stent; stent undersizing; stent malapposition; stent thrombosis

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