Strut fracture of a sirolimus-eluting stent at the ostium of the right coronary artery.

A 75-year-old man implanted with a sirolimus-eluting stent from the ostium to the mid-portion of the right coronary artery (RCA) was admitted to our hospital after a prolonged episode of chest pain. The ECG at chest pain, showing ST depression in leads II, III, aVF, suggested angina pectoris. Coronary angiography showed in-stent restenosis at the ostial lesion of the RCA (panel A) and obscurity of the stent strut (panel B). A 16-slice multidetector CT scan was performed after injection of 100 ml of non-iodinated contrast. The scan showed the strut fracture of the sirolimus-eluting stent at the ostium of the right coronary artery and protrusion of the fractured stent into the right sinus of Valsalva (panel C).