A case of severely calcified neoatherosclerosis after paclitaxel eluting stent implantation.
A 79-year-old male who had a history of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) received coronary angiography (CAG), because of angina pectoris. CAG showed in-stent restenosis of the paclitaxel-eluting stent (PES). Since the devices could not pass the lesion, we performed rotational atherectomy. Although we could not identify the calcified lesion by the optical frequency domain imaging (OFDI) findings because of strong attenuation, the intravascular ultrasound (IVUS) image showed the superficial calcification. On the other hand, strong attenuation in OFDI suggested the presence of foamy macrophage, which was essential for the diagnosis of neoatherosclerosis. We could obtain a favorable result by deploying another drug-eluting stent. While an earlier report showed the calcified neoatherosclerosis following bare-metal stent implantation, we clearly showed the calcified neoatherosclerosis following PES implantation.
Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
Kei
K
Yamamoto
Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan. Electronic address: ksakakura@jichi.ac.jp.
Kenichi
K
Sakakura
Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
Yousuke
Y
Taniguchi
Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
Hiroshi
H
Wada
Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
Shin-Ichi
SI
Momomura
Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
Hideo
H
Fujita
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D017225:Atherectomy, Coronary / Q000379:methods; D002317:Cardiovascular Agents / Q000627:therapeutic use; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000601:surgery; D023903:Coronary Restenosis / Q000175:diagnosis / Q000628:therapy*; D054855:Drug-Eluting Stents / Q000009:adverse effects; D006801:Humans; D008297:Male; D017239:Paclitaxel / Q000627:therapeutic use*; D016896:Treatment Outcome; D061205:Vascular Calcification
D002317:Cardiovascular Agents; D017239:Paclitaxel
In-stent restenosis; Neoatherosclerosis; Paclitaxel-eluting stent; Rotational atherectomy