title: Angioscopically apparent large thrombus and uncovered stent struts 6 months after late stent thrombosis of a paclitaxel-coated nitinol drug-eluting stent implanted in the superficial femoral artery.
abstract: A 74-year-old woman complained of claudication due to in-stent restenosis of bare-metal stents in the right superficial femoral artery, and two Zilver PTXs were deployed. However, hemarthrosis developed, and aspirin and clopidogrel were discontinued. Thirty-six days later, she suddenly felt rest pain in her right leg. Angiography revealed total occlusion at the Zilver PTX implantation site, demonstrating late stent thrombosis. Aspiration and thrombolysis yielded adequate flow and symptom resolution. Follow-up catheterization was scheduled 6 months later. While the Zilver PTX stents were angiographically patent, angioscopy demonstrated a large red thrombus and uncovered stent struts. Therefore, dual antiplatelet therapy was continued.
authors.affiliation: Kansai Rosai Hospital Cardiovascular Center, 3-1-69 Inabaso, Amagasaki, Hyogo, 660-8511, Japan, t.ishihara31@gmail.com.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ishihara
authors.forename: Osamu
authors.initials: O
authors.lastname: Iida
authors.forename: Masaki
authors.initials: M
authors.lastname: Awata
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Shiraki
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Nanto
authors.forename: Masaaki
authors.initials: M
authors.lastname: Uematsu
mesh_terms: D000368:Aged; D000497:Alloys; D000792:Angiography; D017546:Angioscopy / Q000379:methods*; D000972:Antineoplastic Agents, Phytogenic / Q000494:pharmacology; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D005263:Femoral Artery; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D007383:Intermittent Claudication / Q000175:diagnosis / Q000601:surgery; D017239:Paclitaxel / Q000494:pharmacology*; D011475:Prosthesis Failure; D013927:Thrombosis / Q000150:complications / Q000175:diagnosis*; D013997:Time Factors
chemical_list: D000497:Alloys; D000972:Antineoplastic Agents, Phytogenic; C013616:nitinol; D017239:Paclitaxel