title: Worsening late-acquired incomplete stent apposition after sirolimus-eluting stent implantation for a chronic total occlusion lesion.
abstract: A 70-year-old man underwent percutaneous coronary intervention (PCI) using sirolimus-eluting stent (SES) at the just proximal site of left anterior descending coronary artery. Six months after SES implantation, he suffered from late stent thrombosis. Intravascular ultrasound (IVUS) images demonstrated positive remodeling of the vessel, indicating late-acquired incomplete stent apposition (ISA). An angioplasty with a bigger balloon was performed to obtain sufficient stent struts apposition. Twenty-six months after the second PCI, he developed ST-elevation myocardial infarction and his CAG showed re-occlusion of the SES. Optical coherence tomography showed ISA and IVUS revealed further enlargement of the coronary artery around the SES.
authors.affiliation: Department of Cardiology and Hematology, Fukushima Medical University, 1 Hikariga-oka, Fukushima, 960-1295, Japan, nakazato@fmu.ac.jp.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakazato
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Misaka
authors.forename: Nobuo
authors.initials: N
authors.lastname: Sakamoto
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kunii
authors.forename: Shu-Ichi
authors.initials: S
authors.lastname: Saitoh
authors.forename: Yasuchika
authors.initials: Y
authors.lastname: Takeishi
mesh_terms: D000368:Aged; D002908:Chronic Disease; D054059:Coronary Occlusion / Q000601:surgery*; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D003331:Coronary Vessels / Q000473:pathology*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D006801:Humans; D008297:Male; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications; D011475:Prosthesis Failure / Q000009:adverse effects*; D011859:Radiography; D020123:Sirolimus / Q000009:adverse effects*; D041623:Tomography, Optical Coherence; D018084:Ultrasonography, Interventional
chemical_list: D020123:Sirolimus