Kongoji Ken, Ishibashi Yuki, Kotoku Nozomi, Kasahara Mizuho, Yamazaki Hiroshi, Mitarai Takanobu, Kamijima Ryo, Koyama Kohei, Yoneyama Kihei, Tanabe Yasuhiro, Akashi Yoshihiro J
Division of Cardiology, Department of Internal Medicine, Kyorin University School of Medicine, 6-20-2, Shinkawa, Mitaka City, Tokyo, 181-8611, Japan.
Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.
Heart Vessels. 2017 Jun;32(6):777-779. doi: 10.1007/s00380-017-0964-9. Epub 2017 Mar 13.
An expandable polytetrafluoroethylene (ePTFE) covered stent is generally employed to seal coronary artery perforation. The frequency of ePTFE covered stent use is relatively low; thus, only a handful of studies have reported neointimal coverage and endothelialization inside the deployed ePTFE and clinical time course after ePTFE implantation. This case report presents a 78-year-old man treated with an ePTFE covered stent when he suffered from coronary artery perforation after the implantation of two everolimus eluting stents in the left anterior descending artery. Follow-up coronary angiography 9 months after ePTFE covered stent implantation depicted favorable stent patency. Optical coherence tomography showed thin and uneven stent strut coverage at the culprit. Angioscopy also depicted partial white-coated coverage and stent strut exposure. The outcome of this case suggested that long-term dual antiplatelet therapy should be prescribed for preventing thrombosis after ePTFE covered stent implantation.
一种可扩张聚四氟乙烯(ePTFE)覆膜支架通常用于封堵冠状动脉穿孔。ePTFE覆膜支架的使用频率相对较低;因此,仅有少数研究报道了已植入的ePTFE内部的新生内膜覆盖和内皮化情况以及ePTFE植入后的临床病程。本病例报告介绍了一名78岁男性,其在左前降支植入两枚依维莫司洗脱支架后发生冠状动脉穿孔,接受了ePTFE覆膜支架治疗。ePTFE覆膜支架植入9个月后的随访冠状动脉造影显示支架通畅良好。光学相干断层扫描显示罪犯病变处支架小梁覆盖薄且不均匀。血管内镜检查也显示部分白色涂层覆盖及支架小梁暴露。该病例的结果提示,应给予长期双联抗血小板治疗以预防ePTFE覆膜支架植入后的血栓形成。