Slides
Late Stent Malapposition after A Sirolimus-Elutig Stent Implantation
- Operator : Seung-Jung Park
| Late Stent Malapposition after Sirolimus-Elutig Stent Implantation |
| - Operator: Seung-Jung Park, MD, PhD, Korea |
| Case presentation |
The patient was 74 year-old female. She was presented with stable angina 6 months ago. She had a hypercholestrolemia as a coronary risk factor. Baseline ECG was normal. Echocardiography showed good LV function with an EF of 63%. Baseline coronary angiogram before the index-procedure showed a diffuse narrowing at the proximal segment of the LAD,(Figure 1) and a mild stenosis at the proximal segment of the LCX. After predilation with a conventional 2.5x20mm balloon at nominal pressure, the LAD lesion was treated with a 3.0x28 mm Cypher stent implantation at 14 atm (Figure 2). Post-stenting angiography showed an optimally deployed stent without residual stentosis (Figure 3), which was also confirmed by IVUS examination. |
| Six-month follow-up angiographic and IVUS examination |
| Routine angiographic follow-up study was done at 6 months after the index-procedure. It showed a patent site at the proximal LAD (Figure 4). IVUS examination also showed a patent stent. However, a late stent malapposition, defined as a separation of at least stent struts from the intimal surface of the arterial wall, was observed in the middle portion of stent (Figure 5). The patient was discharged with a continuous dual antiplatelet combination of aspirin and plavix. |
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