Kume Teruyoshi, Okura Hiroyuki, Hayashi Hideyuki, Yoshida Kiyoshi
Department of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan.
J Cardiol Cases. 2012 Jul 21;6(4):e116-e117. doi: 10.1016/j.jccase.2012.06.013. eCollection 2012 Oct.
A 48-year old man was admitted to our hospital because of chest pain 20 months after sirolimus-eluting stent implantation to his left anterior descending coronary artery. A coronary angiogram showed a thrombosis of the stented segment, which was successfully treated with bare-metal stent implantation. One month later, optical coherence tomography (OCT) demonstrated late-acquired incomplete stent apposition (ISA) in the stented segment. Additional dilatation was performed using a 4.5 mm balloon. Eleven months later, OCT and intravascular ultrasound images revealed recurrent ISA as a result of progressive vessel remodeling. Serial observation of the stented segment with late-acquired ISA is necessary to understand the natural course of late-acquired ISA and to establish a therapeutic strategy for late-acquired ISA after drug-eluting stent implantation.
一名48岁男性在左前降支冠状动脉植入西罗莫司洗脱支架20个月后因胸痛入住我院。冠状动脉造影显示支架段血栓形成，通过植入裸金属支架成功治疗。1个月后，光学相干断层扫描（OCT）显示支架段出现迟发性不完全支架贴壁（ISA）。使用4.5mm球囊进行了额外扩张。11个月后，OCT和血管内超声图像显示由于进行性血管重塑导致复发性ISA。对出现迟发性ISA的支架段进行连续观察对于了解迟发性ISA的自然病程以及制定药物洗脱支架植入后迟发性ISA的治疗策略是必要的。
