title: Subclinical very late thrombus formation inside and outside the everolimus-eluting stent implanted 3 years prior in a patient with provoked coronary spasms.
abstract: A 63-year-old man with non-ST-elevation acute myocardial infarction had undergone PROMUS Element stent implantation for stenosis with thrombus in the left main trunk and the proximal left anterior descending artery. A 6-month follow-up angiography revealed no restenosis or stent thrombosis, but severe provoked spasms in three vessels, for which medications were administered. Three years later, the patient experienced new-onset rest angina one morning. Optical coherence tomography revealed subclinical very late stent thromboses inside and outside the stent. The patients experienced a severe spasm. Platelet function was adequately reduced, and the cytochrome P450 2C19 genotype indicated an extensive metabolizer phenotype. The spasm may have caused the thromboses.
authors.affiliation: Division of Cardiology, Nagoya City East Medical Center, Nagoya, Japan. shigeito918@gmail.com.|Higashiyama Clinic, The Junshukai Medical Foundation, Nagoya, Japan. shigeito918@gmail.com.
authors.forename: Shigenori
authors.initials: S
authors.lastname: Ito
authors.affiliation: Division of Cardiology, Nagoya City East Medical Center, Nagoya, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ohmori
mesh_terms: D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000175:diagnosis / Q000209:etiology*; D003329:Coronary Vasospasm / Q000175:diagnosis / Q000209:etiology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000601:surgery*; D054855:Drug-Eluting Stents; D004562:Electrocardiography; D000068338:Everolimus / Q000494:pharmacology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D000072658:Non-ST Elevated Myocardial Infarction / Q000175:diagnosis / Q000601:surgery*; D062645:Percutaneous Coronary Intervention
chemical_list: D007166:Immunosuppressive Agents; D000068338:Everolimus
keywords: Acetylcholine; Acute coronary syndrome; Coronary spasm; Drug-eluting stent; Everolimus; Late stent thrombosis