title: Successful treatment of very late drug-eluting stent thrombosis using bare-metal stent evaluated using intravascular ultrasound and optical frequency domain imaging.
abstract: A 65-year-old man who underwent percutaneous coronary intervention with sirolimus-eluting stents (SESs) 2 years ago was admitted with recurrent acute chest pain. Coronary angiography showed thrombotic occlusion within the SESs. After aspiration thrombectomy, multi-focal peri-stent contrast staining (PSS) was observed. Optical frequency domain imaging (OFDI) showed intracoronary thrombus, incomplete stent apposition (ISA), and multiple inter-strut hollows. Intravascular ultrasound (IVUS) images showed positive vessel remodeling. We deployed bare-metal stents in the SESs. Follow-up angiography showed no in-stent restenosis or PSS. OFDI showed well-covered stent surface with homogeneous neointima, without ISA. Additionally, IVUS images showed that the vessel remodeling had not worsened.
authors.affiliation: Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Matsumoto
authors.affiliation: Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan. ehara@med.osaka-cu.ac.jp.
authors.forename: Shoichi
authors.initials: S
authors.lastname: Ehara
authors.affiliation: Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Hasegawa
authors.affiliation: Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
authors.forename: Mikumo
authors.initials: M
authors.lastname: Sakaguchi
authors.affiliation: Nishinomiya Watanabe Cardiovascular Center, Hyogo, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Yoshikawa
authors.affiliation: Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
authors.forename: Kenei
authors.initials: K
authors.lastname: Shimada
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000601:surgery*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000601:surgery*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D008297:Male; D062645:Percutaneous Coronary Intervention; D011474:Prosthesis Design; D012086:Reoperation; D020123:Sirolimus / Q000494:pharmacology*; D015607:Stents; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013997:Time Factors; D041623:Tomography, Optical Coherence / Q000379:methods*; D018084:Ultrasonography, Interventional / Q000379:methods
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus
keywords: Coronary artery disease; Intravascular ultrasound; Optical frequency domain imaging; Sirolimus-eluting stent; Very late stent thrombosis