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一名接受西罗莫司洗脱支架经皮冠状动脉介入治疗的患者发生极晚期支架血栓复发：机制相同还是不同？

Recurrent episode of very late stent thrombosis in a patient who underwent percutaneous coronary intervention with sirolimus-eluting stent: Same or different mechanism?

作者信息

Suh Soon Yong, Kang Woong Chol, Ahn Taehoon

机构信息

Cardiology Division, Department of Internal Medicine, Heart Center, Gil Hospital, Gachon University, 1198 Kuwol-dong, Namdong-gu, Incheon 405-760, Republic of Korea.

出版信息

J Cardiol Cases. 2011 Dec 6;5(1):e8-e11. doi: 10.1016/j.jccase.2011.10.007. eCollection 2012 Feb.

DOI:10.1016/j.jccase.2011.10.007
PMID:30532891
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6265395/
Abstract

We describe a case of a young patient with a recurrent episode of very late stent thrombosis (VLST) in whom the sirolimus-eluting stent was implanted on the culprit lesion in the left anterior descending artery. The present case showed when the etiology of VLST was not clear or in doubt of stent fracture, vigorous investigation for other causes using high resolution technology such as intravascular ultrasound or computed tomography angiography might be helpful for prevention of catastrophic events such as VLST.

摘要

我们描述了一例年轻患者发生极晚期支架血栓形成（VLST）复发的病例，该患者在左前降支罪犯病变处植入了西罗莫司洗脱支架。本病例表明，当VLST的病因不明或怀疑支架断裂时，使用血管内超声或计算机断层血管造影等高分辨率技术对其他原因进行积极检查，可能有助于预防诸如VLST等灾难性事件。

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1
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2
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本文引用的文献

1
Multiple sequential complications after sirolimus-eluting stent implantation: very late stent thrombosis, stent fracture, in-stent restenosis, and peri-stent aneurysm.西罗莫司洗脱支架置入术后的多重连续并发症：极晚期支架血栓形成、支架断裂、支架内再狭窄和支架周围动脉瘤。
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Clinical and angiographic outcomes with sirolimus-eluting stents in total coronary occlusions: the ACROSS/TOSCA-4 (Approaches to Chronic Occlusions With Sirolimus-Eluting Stents/Total Occlusion Study of Coronary Arteries-4) trial.在完全闭塞病变中应用西罗莫司洗脱支架的临床和血管造影结果：ACROSS/TOSCA-4 试验（西罗莫司洗脱支架治疗慢性闭塞病变/冠状动脉完全闭塞研究 4）。
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Detection of stent fractures: a comparison of 64-slice CT, conventional cine-angiography, and intravascular ultrasonography.
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4
Classification and potential mechanisms of intravascular ultrasound patterns of stent fracture.支架断裂的血管内超声图像分类及潜在机制
Am J Cardiol. 2009 Mar 15;103(6):818-23. doi: 10.1016/j.amjcard.2008.11.051.
5
Stent fracture: a biomaterial scientist's responsibility or an interventionist's onus?支架断裂：是生物材料科学家的责任还是介入治疗专家的职责？
Indian Heart J. 2007 Jan-Feb;59(1):5-8.
6
Drug-eluting stent thrombosis: results from the multicenter Spanish registry ESTROFA (Estudio ESpañol sobre TROmbosis de stents FArmacoactivos).药物洗脱支架血栓形成：来自西班牙多中心注册研究ESTROFA（西班牙药物洗脱支架血栓形成研究）的结果。
J Am Coll Cardiol. 2008 Mar 11;51(10):986-90. doi: 10.1016/j.jacc.2007.10.057.
7
Serial angiographic and intravascular ultrasound analysis of late stent strut fracture of sirolimus-eluting stents in native coronary arteries.
Int J Cardiol. 2008 Nov 12;130(2):255-9. doi: 10.1016/j.ijcard.2007.08.082. Epub 2007 Dec 21.
8
Incomplete stent apposition and very late stent thrombosis after drug-eluting stent implantation.药物洗脱支架植入术后的支架贴壁不全及极晚期支架血栓形成。
Circulation. 2007 May 8;115(18):2426-34. doi: 10.1161/CIRCULATIONAHA.106.658237.
9
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Circulation. 2006 Feb 28;113(8):1108-13. doi: 10.1161/CIRCULATIONAHA.105.600155. Epub 2006 Feb 20.
10
Sirolimus-eluting stent fracture with thrombus, visualization by optical coherence tomography.西罗莫司洗脱支架骨折伴血栓形成，光学相干断层扫描成像
Eur Heart J. 2006 Jun;27(12):1389. doi: 10.1093/eurheartj/ehi542. Epub 2005 Oct 24.