Miyazaki Shinichiro, Hiasa Yoshikazu, Kishi Koichi
Department of Cardiology, Tokushima Red Cross Hospital, Komatsushima 773-8502, Japan.
J Invasive Cardiol. 2010 Aug;22(8):E162-5.
The clinical significance of late-acquired incomplete stent apposition (ISA) after drug-eluting stent (DES) implantation remains controversial. In a case report, late-acquired ISA occurred after a DES was implanted into the subintimal space during percutaneous coronary intervention (PCI) for chronic total occlusion (CTO). However, to our knowledge, there is no report of very late thrombosis of such a case. The present case report describes a late-acquired ISA occurring in the true lumen side external to the subintimally located sirolimus-eluting stent implanted during PCI for a CTO, resulting in very late stent thrombosis (VLST). The late-acquired ISA was observed by intravascular ultrasound and optical coherence tomography at the time of follow-up angiography after VLST.
药物洗脱支架（DES）植入术后迟发性获得性不完全支架贴壁（ISA）的临床意义仍存在争议。在一份病例报告中，经皮冠状动脉介入治疗（PCI）慢性完全闭塞（CTO）时，DES植入到内膜下间隙后发生了迟发性获得性ISA。然而，据我们所知，尚无此类病例发生极晚期血栓形成的报道。本病例报告描述了1例在CTO的PCI期间植入的西罗莫司洗脱支架内膜下侧真腔侧发生迟发性获得性ISA，导致极晚期支架血栓形成（VLST）。在VLST发生后的随访血管造影时，通过血管内超声和光学相干断层扫描观察到迟发性获得性ISA。
