Mehrpooya Maryam, Vahidi Hamed, Taheri Maryam, Ebrahimi Pouya
Department of Cardiology Imam Khomeini Hospital, Tehran University of Medical Sciences Tehran Iran.
Tehran Heart Center, Cardiovascular Disease Research Institute Tehran University of Medical Sciences Tehran Iran.
Clin Case Rep. 2025 Feb 10;13(2):e70212. doi: 10.1002/ccr3.70212. eCollection 2025 Feb.
Stent crumpling is a rare but potentially life-threatening complication of percutaneous coronary intervention (PCI). This report highlights a case of stent crumpling during a PCI procedure, its management, and the importance of advanced imaging techniques in diagnosing and addressing such complications. A 78-year-old man was admitted for elective PCI on the left anterior descending (LAD) artery following an acute anterior ST-segment elevation myocardial infarction (STEMI) treated with thrombolytic therapy. The patient exhibited significant ischemic changes on his electrocardiogram (ECG) and experienced persistent angina. During the PCI, two overlapping stents were deployed in the LAD. Post-dilation led to slow flow and thrombus formation in the LAD, rapidly progressing to cardiac arrest. Immediate resuscitation and intracoronary thrombolytic therapy were initiated. Intravascular ultrasound (IVUS) revealed stent crumpling, so the proximal stent folded within the vessel lumen. To solve this issue, the crumpled stent was crushed behind a newly deployed stent, followed by post-dilation, which restored TIMI flow grade III in the LAD.
支架皱缩是经皮冠状动脉介入治疗（PCI）中一种罕见但可能危及生命的并发症。本报告重点介绍了一例PCI手术过程中发生的支架皱缩病例、其处理方法以及先进成像技术在诊断和处理此类并发症中的重要性。一名78岁男性在接受溶栓治疗的急性前壁ST段抬高型心肌梗死（STEMI）后，因择期对左前降支（LAD）动脉进行PCI入院。患者心电图（ECG）显示有明显的缺血性改变，并持续心绞痛。在PCI过程中，在LAD中植入了两个重叠的支架。后扩张导致LAD血流缓慢和血栓形成，并迅速发展为心脏骤停。立即开始进行复苏和冠状动脉内溶栓治疗。血管内超声（IVUS）显示支架皱缩，近端支架在血管腔内折叠。为解决这个问题，将皱缩的支架在新植入的支架后进行挤压，随后进行后扩张，恢复了LAD的TIMI血流3级。
