Cardiology Unit, S. Elia Hospital, Caltanissetta, Italy.
Catheter Cardiovasc Interv. 2013 Jan 1;81(1):52-6. doi: 10.1002/ccd.24414. Epub 2012 May 2.
Despite drug eluting stents (DES), as compared to bare metal stents, have reduced in-stent restenosis, complex and long lesions remains a challenge for interventional cardiologist. Their treatment is often associated with an unfavorable outcome, related to in-stent restenosis, stent thrombosis, and target lesion revascularization. These complications may derive from the contact between metallic structures and coronary artery endothelium, and consequent overexpression of platelet activating factors, growth factors, and inflammatory cytokines. Recently, an additional mechanism has emerged as new cause of these complications: "stent fracture." Several factors are involved in this phenomenon including material and stent platform, target vessel features, stent implantation technique, and implant duration. We reported a case of 69 years old man with rare early and complex DES fractures on right coronary that caused acute coronary syndrome 36 hr after a previous percutaneous coronary intervention.
尽管药物洗脱支架（DES）与裸金属支架相比，已经降低了支架内再狭窄的发生率，但复杂且长的病变仍然是介入心脏病学家面临的挑战。这些病变的治疗往往与不利的结果相关，包括支架内再狭窄、支架血栓形成和靶病变血运重建。这些并发症可能源于金属结构与冠状动脉内皮之间的接触，以及随后血小板激活因子、生长因子和炎症细胞因子的过度表达。最近，一种新的并发症机制出现了：“支架断裂”。多种因素参与了这一现象，包括材料和支架平台、靶血管特征、支架植入技术和植入持续时间。我们报告了一例 69 岁男性，在先前经皮冠状动脉介入治疗 36 小时后，因右冠状动脉罕见的早期和复杂 DES 断裂导致急性冠状动脉综合征。
