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Corresponding author: Dr Paul D. Williams, Department of Cardiology, James Cook University Hospital, Marton Road, Middlesbrough TS4 3BW, UK. Tel.: +44-1642 835894.
A 65-year-old man with a history of bare-metal stent deployment to the proximal left
anterior descending coronary artery 16 years previously was given thrombolysis for
an anterior ST-elevation myocardial infarction (Fig. 1A). Coronary angiography the next day showed a normal flow in the left anterior descending
artery and a patent stent (Fig. 1B, arrowheads) with no cause for the acute event identified.
Figure 1Electrocardiogram on admission (A). Initial coronary angiogram (B). Arrowheads show the location of the 16-year-old stent. Optical coherence tomography of left
anterior descending coronary artery stent (C, D). Arrowheads indicate stent struts; large arrow denotes residual lipid pool; small arrow indicates the plaque rupture cavity.
