title: Inflammation and impaired wound healing after zotarolimus-eluting stent implantation.
abstract: An 86-year-old man died suddenly 5 months after implantation of a zotarolimus-eluting stent. Two zotarolimus-eluting stents were placed to treat a highly calcified diffuse lesion in the proximal-to-mid right coronary artery. The lesion was fully covered by the two stents, and intravascular ultrasound showed complete stent apposition. However, an X-ray at autopsy showed that the proximal stent was fractured. Although we thought that thrombotic occlusion at the fracture site might have caused his sudden death, no thrombus was present. In addition, in the other sites where the stents were optimally dilated, there was stent malapposition and peri-strut inflammation including macrophage infiltration, giant cells, polymer phagocytosis, and neovascularization in the neointima. Even with a second-generation drug-eluting stent, such as the zotarolimus-eluting stent, wound healing may be impaired at the stent-injured vessel site.
authors.affiliation: Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Yoneda
authors.forename: Shichiro
authors.initials: S
authors.lastname: Abe
authors.forename: Isao
authors.initials: I
authors.lastname: Taguchi
authors.forename: Nobuhide
authors.initials: N
authors.lastname: Masawa
authors.forename: Katsumi
authors.initials: K
authors.lastname: Inoue
authors.forename: Teruo
authors.initials: T
authors.lastname: Inoue
mesh_terms: D000369:Aged, 80 and over; D001344:Autopsy; D003331:Coronary Vessels / Q000473:pathology / Q000601:surgery; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D017809:Fatal Outcome; D006801:Humans; D007249:Inflammation / Q000209:etiology / Q000473:pathology*; D008297:Male; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000009:adverse effects*; D020123:Sirolimus / Q000009:adverse effects / Q000031:analogs & derivatives*; D014945:Wound Healing / Q000187:drug effects*
chemical_list: C489443:zotarolimus; D020123:Sirolimus