Acute left main coronary occlusion caused by stent fracture, peri-stent aneurysm formation, and very-late stent thrombosis: revisiting the dark side of drug-eluting stents.

A patient presented with acute distal left main occlusion as a result of very late stent thrombosis of 2 drug-eluting stents. Intravascular ultrasound imaging confirmed the presence of a peri-stent aneurysm coupled with malapposition at the site of a stent fracture, reflecting an abnormal vascular response to drug-eluting stents.