> Cases

Late Stent Thrombosis at the Proximal Segment of Sirolimus-Eluting Stent
- Operator: Myeong-Ki Hong, MD, Bong-Ki Lee, MD, Korea

A 65-year old female patient was admitted with intermittent resting chest pain for 1 week. Her risk factors were hypertension and diabetes mellitus. The patient had been treated with a 3.5 x 30mm Terumo stent at the middle segment of the left anterior descending artery (LAD) 15 months ago. Eight months after stent implantation, the patient had been readmitted with recurrent chest pain, and underwent stent re-implantation with a 3.5 x 33mm Cypher stent at the in-stent restenosis site of the LAD (Figure 1, pre-intervention; Figure 2, stent implantation; Figure 3, post-intervention). Then, she was discharged and had been on continuous dual antiplatelet medication with aspirin and clopidogrel. Seven months after the second stenting, she had been suffered recurrent chest pain for 1 week and re-admitted for follow-up coronary angiography. Cardiac enzymes, such as CK-MB and Troponin I, and echocardiogram were normal. The coronary angiogram showed total occlusion of proximal LAD with intraluminal thrombus extended from the proximal segment of Cypher stent (Figure 4). She was treated with consecutive stenting with two 3.5 x 23mm Cypher stents at the proximal LAD occlusion site (Figure 5, Figure 6). The coronary angiography after the stenting showed restoration of normal coronary blood flow (Figure 7).
Bon-Kwon Koo2004-03-12
There is some limitations for using DES. In this era, I think classical, conventional PCI (using non-drug eluting stent) was one of the choice for this case. Once more time, I will use non-DES for this patient because the lumen of LAD was over 3.5mm.
Marcelo Ribeiro2004-04-04
Wasn't the angiographic picture of the acute event more suggestive of proximal border restenosis with superimposed thrombosis?
Sign in to leave a comment.
CardioVascular Research Foundation (CVRF)
2nd Floor, Asan Institute for Education & Research, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea
Tel_82.2.3010.4792 | Fax_82.2.475.6898
재단법인 심장혈관연구재단
대표이사 박승정 | 서울시 송파구 올림픽로43길 88, 서울아산병원 아산교육연구관 2층 | 사업자등록번호 215-82-06387
개인정보 관리책임자_노순정 | 전화번호_02.3010.4792 | 팩스번호_02.475.6898
Copyright © CVRF, Seoul, Korea. All rights reserved.