A Novel Utilization of a Peripheral Self-Expanding Nitinol Stent to Treat Recurrent Coronary Stent Fracture

This case presents the novel use of a peripheral self-expanding nitinol stent to treat recurrent coronary stent fractures (SFs) in a saphenous vein graft (SVG) previously treated with 2 layers of drug-eluting stents in an 84-year-old man. Angiographic follow-up at 16 months showed an intact stent. SF is a rare complication, in this case likely owing to shear mechanical forces between the SVG and the ascending aorta, in addition to the extrinsic compression of vessel calcification. Independent of the mechanisms, if the first metallic (ie, stainless steel or cobalt-chromium) balloon-expandable coronary stent does fracture, the second one is likely to fail as well. The implantation of a peripheral self-expanding nitinol stents in this patient overcame those mechanical forces. This may represent a novel approach to treat coronary SF, especially in the SVG. Additionally, this case highlights the importance of intravascular imaging in assessing lesion characteristics and guiding stent implantation, potentially preventing SF.