Acute myocardial infarction as a consequence of stent fracture and plaque rupture after sirolimus-eluting stent implantation.

Stent fracture (SF) is emerging as one of the leading causes of late cardiac events after sirolimus-eluting stent (SES) implantation. A 44-year old man was admitted with ST-segment elevated myocardial infarction 22 months after treatment with SES. SF was confirmed by fluoroscopy, intravascular ultrasound study (IVUS) and computerized tomographic study. IVUS demonstrated a soft, ruptured plaque at the site of the SF where the plaque was not covered by the stent strut. This case suggests that rupture of vulnerable plaque because of SF led to thrombosis and acute myocardial infarction.