First case of stenting of a vulnerable plaque in the SECRITT I trial-the dawn of a new era?
BACKGROUND
A 63-year-old man presented with class II anginal symptoms.


METHODS
Cardiac catheterization, intravascular ultrasound (IVUS) virtual histology, optical coherence tomography and off-line palpography.


METHODS
The patient was diagnosed as having a culprit lesion in the left circumflex artery and a vulnerable plaque in the left anterior descending artery.


RESULTS
The culprit lesion was treated with two overlapping drug-eluting stents. The vulnerable plaque was then treated with a self-expanding stent tailored to shield vulnerable plaques (vProtect Luminal Shield). After dilatation of the stent with a low-pressure balloon, IVUS and optical coherence tomography showed excellent apposition of the stent to the vessel wall, with no signs of tissue prolapse or edge dissections. At the 6-month follow-up appointment, the stent showed complete tissue coverage without signs of in-stent restenosis.


CONCLUSIONS
Six months of follow-up has demonstrated that a patient with an IVUS-derived, thin capped fibroatheroma was successfully treated with a stent tailored to shield vulnerable plaques.
Department of Interventional Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam 3015 GD, The Netherlands.
Steve
S
Ramcharitar
Nieves
N
Gonzalo
Robert Jan
RJ
van Geuns
Hector M
HM
Garcia-Garcia
Joanna J
JJ
Wykrzykowska
Jurgen M R
JM
Ligthart
Evelyn
E
Regar
Patrick W
PW
Serruys
D000787:Angina Pectoris / Q000209:etiology / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D054855:Drug-Eluting Stents; D006801:Humans; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional