Iguchi Tomokazu, Hasegawa Takao, Nishimura Satoshi, Nakata Shinji, Kataoka Toru, Ehara Shoichi, Shimada Kenei, Hanatani Akihisa, Muro Takashi, Yoshiyama Minoru
Department of Internal Medicine and Cardiology, Osaka City University, Osaka, Japan.
J Cardiol Cases. 2011 Aug 27;4(3):e152-e155. doi: 10.1016/j.jccase.2011.08.001. eCollection 2011 Dec.
Late adverse events including late stent thrombosis and late catch-up phenomenon after percutaneous coronary intervention have been a serious clinical problem in the drug-eluting stent era. Recently, peri-stent contrast staining, namely extension of incomplete stent apposition was reported following drug-eluting stent implantation. Here, we report a case of late incomplete stent apposition with late stent restenosis 3 years after sirolimus-eluting stent implantation. We evaluated this restenotic site by intravascular ultrasound (IVUS) and optical coherence tomography (OCT). Though IVUS demonstrated irregular structure within stent at the stenotic site, OCT detected unusual bell-shaped image of late stent restenosis with extension of incomplete stent apposition.
晚期不良事件，包括经皮冠状动脉介入治疗后的晚期支架血栓形成和晚期追赶现象，在药物洗脱支架时代一直是一个严重的临床问题。最近，有报道称药物洗脱支架植入后出现支架周围造影剂染色，即不完全支架贴壁扩展。在此，我们报告一例西罗莫司洗脱支架植入3年后出现晚期不完全支架贴壁并伴有晚期支架再狭窄的病例。我们通过血管内超声（IVUS）和光学相干断层扫描（OCT）对这个再狭窄部位进行了评估。尽管IVUS显示狭窄部位支架内结构不规则，但OCT检测到晚期支架再狭窄的异常钟形图像，并伴有不完全支架贴壁扩展。
