RE-INFARCTION OF THE TARGET VESSEL, SEVEN YEARS AFTER AN UNDERSIZED BARE METAL STENT DEPLOYMENT

Abstract

Stent sizing and apposition have been shown to be determinants of clinical
outcome and stent under-expansion is associated with both technique/operatorlesion related factors. Here we report a case of re-infarction of the target vessel,seven years after an undersized bare metal stent (BMS) deployment to emphasize again on importance of the effect of stent size and type and undersize hazardous effect on clinical outcome of patients. A 59-year-old man, with a history of previous primary percutaneous coronary intervention (PCI) about 7 years ago on left anterior descending artery was admitted for acute anterior ST
elevation myocardial infarction. Our patient's clinical course was an example of
under sized BMS stent in primary PCI setting and re –MI and we think undersized
stent itself without in stent restenosis can change rheolytic and hemodynamic
condition in the stent edge and in hyper coagulable state produce a nidus for
thrombus and myocardial infarction and IVUS guided PCI is the best strategy to
prevent this event.