Mabuchi Tomohito, Fujino Susumu, Yamaguchi Masato, Noji Yoshihiro, Ichise Taro, Aoyama Takahiko
Department of Cardiology, Fukui Prefectural Hospital, Yotsui 2-8-1, Fukui, Fukui, 910-0846, Japan,
Cardiovasc Interv Ther. 2013 Oct;28(4):388-93. doi: 10.1007/s12928-013-0175-y. Epub 2013 Apr 6.
A 58-year-old man was admitted to our hospital with acute anterior myocardial infarction that occurred 4 years after single sirolimus-eluting stent (SES) implantation in the left anterior descending artery. He had been undergoing continuous dual antiplatelet therapy. Emergency coronary angiography showed total thrombotic occlusion and peri-stent contrast staining at the SES site. The lesion was evaluated using intravascular ultrasound (IVUS) and optical coherence tomography (OCT) after thrombectomy. Vessel remodeling was detected on IVUS, and multiple interstrut hollows and thrombi were observed on OCT. These findings were associated with very late stent thrombosis after SES implantation.
一名58岁男性因急性前壁心肌梗死入住我院，此次心肌梗死发生在其左前降支单枚西罗莫司洗脱支架（SES）植入4年后。他一直在接受持续的双联抗血小板治疗。急诊冠状动脉造影显示SES部位完全血栓闭塞及支架周围造影剂染色。血栓清除术后，使用血管内超声（IVUS）和光学相干断层扫描（OCT）对病变进行评估。IVUS检测到血管重塑，OCT观察到多个支架小梁间空洞及血栓。这些发现与SES植入后极晚期支架血栓形成有关。
