title: Optical coherence tomography-guided treatment of very late stent thrombosis caused by inaccurate stent deployment in a bifurcation.
abstract: : A 65-year-old man presented at our institution with anterior wall reinfarction, due to very late stent thrombosis, 4 years after primary angioplasty on the first bifurcation of the left anterior descending artery. Using intravascular optical coherence tomography, we identified stent malapposition in the proximal left anterior descending artery, occurring during the first primary angioplasty, as the probable cause of the very late stent thrombosis. Imaging with optical coherence tomography guided our treatment strategy of mechanical and pharmacological thrombectomy, followed by staged stent postdilatation.
authors.affiliation: Cardiac Catheterization Laboratory, Cardiothoracic and Vascular Department, University of Pisa, Pisa, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: De Caro
authors.forename: Marco
authors.initials: M
authors.lastname: De Carlo
authors.forename: Anna S
authors.initials: AS
authors.lastname: Petronio
mesh_terms: D000077284:Abciximab; D000284:Administration, Oral; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000295:instrumentation*; D056988:Anterior Wall Myocardial Infarction / Q000628:therapy*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D000925:Anticoagulants / Q000008:administration & dosage; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage; D007262:Infusions, Intravenous; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D000068799:Prasugrel Hydrochloride / Q000008:administration & dosage; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D012008:Recurrence; D015607:Stents; D017131:Thrombectomy / Q000379:methods; D013997:Time Factors; D041623:Tomography, Optical Coherence
chemical_list: D000911:Antibodies, Monoclonal; D000925:Anticoagulants; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D000068799:Prasugrel Hydrochloride; D000077284:Abciximab