Imaging & Physiology > Cases

OCT Finding of Very Late Thrombosis after SES Stenting
- Operator: Buxing Chen, MD
Clinical Information

- Relevant clinical history and physical exam:
A 44-year old male with unstable angina was referred to our hospital on June 1, 2005.
proximal segment of the left anterior descending coronary artery (LAD) 95% stenosis, a distal segment of LAD 50%stenosis, a middle segment of the left circumflex artery (LCX) 30-40% stenosis.
A 3.0×28mm sirolimus-eluting stent was deployed in proximal segment of LAD using 18 atmospheres. A post-intervention coronary angiogram revealed excellent . Clopidogrel was discontinued 9 months after stenting, but aspirin, simvastatin, and ß-blocker were continued.

- Relevant test results prior to catheterization:
On May 24,2007, repeated angiography showed the SES in LAD was irregular. (Figure 1, Figure 2) On July 19, 2007, the patient experienced persistent chest pain lasting 2 hours, and he was diagnosed as acute anterior myocardial infarction in another hospital .The patient was received intravenous thrombolytic therapy with 2 million units of Urokinase, peak creatine kinase was 5880 U/L,and creatine kinase-MB 439.7 U/L. One day after the myocardial infarction, he was transferred to our hospital.

- Relevant catheterization findings:
Twelve days after AMI,coronary angiography was repeated, (Figure 3, Figure 4) and the result was similar to two months ago. OCT was performed in SES location of LAD. OCT showed aneurysm, stent strut malapposition in the SES location. (Figure 5)

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