Successful treatment of very late drug-eluting stent thrombosis using bare-metal stent evaluated using intravascular ultrasound and optical frequency domain imaging

Cardiovasc Interv Ther. 2017 Apr;32(2):159-164. doi: 10.1007/s12928-016-0384-2. Epub 2016 Mar 16.

Abstract

A 65-year-old man who underwent percutaneous coronary intervention with sirolimus-eluting stents (SESs) 2 years ago was admitted with recurrent acute chest pain. Coronary angiography showed thrombotic occlusion within the SESs. After aspiration thrombectomy, multi-focal peri-stent contrast staining (PSS) was observed. Optical frequency domain imaging (OFDI) showed intracoronary thrombus, incomplete stent apposition (ISA), and multiple inter-strut hollows. Intravascular ultrasound (IVUS) images showed positive vessel remodeling. We deployed bare-metal stents in the SESs. Follow-up angiography showed no in-stent restenosis or PSS. OFDI showed well-covered stent surface with homogeneous neointima, without ISA. Additionally, IVUS images showed that the vessel remodeling had not worsened.

Keywords: Coronary artery disease; Intravascular ultrasound; Optical frequency domain imaging; Sirolimus-eluting stent; Very late stent thrombosis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Coronary Angiography
  • Coronary Artery Disease / diagnosis
  • Coronary Artery Disease / surgery*
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / surgery*
  • Drug-Eluting Stents / adverse effects*
  • Follow-Up Studies
  • Graft Occlusion, Vascular / diagnosis
  • Graft Occlusion, Vascular / surgery*
  • Humans
  • Immunosuppressive Agents / pharmacology
  • Male
  • Percutaneous Coronary Intervention
  • Prosthesis Design
  • Reoperation
  • Sirolimus / pharmacology*
  • Stents
  • Surgery, Computer-Assisted / methods*
  • Time Factors
  • Tomography, Optical Coherence / methods*
  • Ultrasonography, Interventional / methods

Substances

  • Immunosuppressive Agents
  • Sirolimus