title: Pathological finding of sirolimus-eluting stent (SES) restenosis lesion with black hole appearance on intravascular ultrasound.
abstract: Restenosis still occurs, even with the sirolimus-eluting stent (SES), and the precise mechanisms have not yet been elucidated. In the present case, focal in-stent stenosis was discovered on angiography 16 months after SES implantation. Intravascular ultrasound revealed an echolucent homogeneous zone, which has been termed "black hole". A sample of stenotic tissue retrieved by aspiration revealed neointimal hyperplasia, composed of proteoglycans and smooth muscle cells with scanty cellularity. Furthermore, infiltration of many macrophages and T lymphocytes coexisted in the restenotic tissue. These findings suggest that delayed healing is 1 of the mechanisms of SES restenosis.
authors.affiliation: Department of Cardiology, Matsue Red Cross Hospital, Japan. kenji-g@go4.enjoy.ne.jp
authors.forename: Kenji
authors.initials: K
authors.lastname: Goto
authors.forename: Nobuo
authors.initials: N
authors.lastname: Shiode
authors.forename: Kinya
authors.initials: K
authors.lastname: Shirota
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Fukuda
authors.forename: Fumiyo
authors.initials: F
authors.lastname: Kitamura
authors.forename: Koichi
authors.initials: K
authors.lastname: Tominaga
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Kato
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Miura
authors.forename: Katsumi
authors.initials: K
authors.lastname: Inoue
authors.forename: Masakiyo
authors.initials: M
authors.lastname: Nobuyoshi
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000295:instrumentation*; D001707:Biopsy, Needle; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology / Q000628:therapy; D054855:Drug-Eluting Stents; D006801:Humans; D006965:Hyperplasia; D008264:Macrophages / Q000473:pathology; D008297:Male; D020123:Sirolimus / Q000008:administration & dosage*; D013601:T-Lymphocytes / Q000473:pathology; D017539:Tunica Intima / Q000473:pathology; D018084:Ultrasonography, Interventional
chemical_list: D002317:Cardiovascular Agents; D020123:Sirolimus