Stent underexpansion is a well known risk factor for stent thrombosis. We report a case of acute stent thrombosis which occurred after primary percutaneous coronary intervention to the right coronary artery for an inferior ST-elevation myocardial infarction. Minutes after completion of the procedure, the patient had acute stent thrombosis, manifested by new chest pain and new ST-elevation. IVUS showed the stent to be underexpanded. Despite high pressure balloon inflation, the stent remained underexpanded. This was then managed with rotational atherectomy within the underexpanded stent, followed by high-pressure balloon dilatation and deployment of another stent within it.
Keywords: Rotablation; Stentablation.
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