Ruptured “non-culprit” in-stent neoatherosclerosis during ST-segment elevation acute myocardial infarction

A 53-year-old man, with previous bare metal stent (BMS) implantation in the left circumflex (LCX) coronary artery 10 years ago (Panel A, yellow arrows), was admitted with a large anterior ST-segment elevation acute myocardial infarction (STEMI). Urgent coronary angiography showed a total occlusion of the left anterior descending (LAD) coronary artery (Panel B, white arrow) and also a severe in-stent restenosis (ISR) in the LCX (Panel B and Panel C, yellow arrows). A drug-eluting stent (DES) was implanted successfully in the LAD (Panel C, white arrows). Three days later a new coronary angiography was performed in order to treat ...