title: Local aneurysmal dilatation mimicking stent malapposition and concurrent vulnerable plaque within neointima of normal lumen after drug-eluting stent implantation: primary new findings from optical coherence tomography.
abstract: Very late stent thrombosis is a life-threatening complication of implantation of drug-eluting stent (DES). The mechanisms are still unidentified. Stent malapposition is supposed to be one debated reason. Here we report a case of 33 months after DES implanted. Observed by optical coherence tomography, we detected a lipid-rich plaque with defective fibrous cap within the neointima and many local aneurysmal dilatations between stent struts, which mimic “malapposition” on the angiogram. These indicated that vulnerable plaque hidden in the neointima at the stent segment might be a potential mechanism of very late stent thrombosis after DES implantation.
authors.affiliation: Clinical and Research Center for Coronary Disease, Fu Wai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China.
authors.forename: Yuan-lin
authors.initials: YL
authors.lastname: Guo
authors.forename: Yue-jin
authors.initials: YJ
authors.lastname: Yang
authors.forename: Zhan
authors.initials: Z
authors.lastname: Gao
authors.forename: Jie
authors.initials: J
authors.lastname: Qian
mesh_terms: D003323:Coronary Aneurysm / Q000473:pathology*; D004108:Dilatation, Pathologic; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D058426:Neointima / Q000175:diagnosis*; D058226:Plaque, Atherosclerotic / Q000175:diagnosis*; D041623:Tomography, Optical Coherence / Q000379:methods*