Focal in-stent restenosis and in-stent thrombosis within the same bare-metal stent 5 years after deployment in a saphenous vein graft.
Complications of percutaneous coronary intervention include in-stent restenosis (ISR) and in-stent thrombosis (IST) which have different underlying pathophysiological processes and different treatment strategies. ISR is primarily due to excessive neointimal growth and occurs in 20-30% of bare-metal stents (BMS). Drug-eluting stents (DES) have decreased the rates of ISR (< 10%), but are potentially associated with increased IST related to delayed arterial healing and stent strut exposure. ISR of BMS typically occurs within 6 months of stent deployment. IST usually occurs within 12 months of DES deployment. We present a case of focal ISR and IST within the same BMS, confirmed with intravascular ultrasound, 5 years after deployment in a saphenous vein graft.
Ponnuthurai
Francis A
FA
Department of Cardiology, Level 2, John Radcliffe Hospital, Headley Way, Headington, Oxford, Oxfordshire OX3 9DU, United Kingdom. larryponnuthurai@ googlemail.com
van Gaal
William J
WJ
Channon
Keith M
KM
D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods*; D023903:Coronary Restenosis / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D012501:Saphenous Vein / Q000637:transplantation; D015607:Stents; D015912:Thrombolytic Therapy / Q000379:methods; D013997:Time Factors; D018084:Ultrasonography, Interventional