Sonoda Shinjo, Okazaki Masahiro, Iwataki Mai, Kashiyama Kuninobu, Muraoka Yoshitaka, Kamezaki Fumihiko, Tsuda Yuki, Araki Masaru, Shimajiri Kouhei, Inoue Katsumi, Otsuji Yutaka
Department of Cardiovascular Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
Department of Pathology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
J Cardiol Cases. 2012 May 15;6(5):e126-e129. doi: 10.1016/j.jccase.2012.04.007. eCollection 2012 Nov.
This case report describes an autopsy case of very late stent thrombosis, which was associated with intravascular ultrasound findings of late-acquired stent malapposition with thrombotic materials and marked positive vascular remodeling at the site of the sirolimus-eluting stent implantation. Histopathological examination showed both destructive and proliferative reactions had occurred in the same stented coronary arterial wall 44 months after sirolimus-eluting stent implantation. Long-lasting severe local inflammation beyond healing reaction, causing vessel enlargement, may be related to very late stent thrombosis.
本病例报告描述了一例极晚期支架血栓形成的尸检病例,其与血管内超声检查结果相关,显示晚期获得性支架贴壁不良并伴有血栓形成物质,以及西罗莫司洗脱支架植入部位明显的阳性血管重塑。组织病理学检查显示,在西罗莫司洗脱支架植入44个月后,同一冠状动脉支架置入部位的血管壁同时出现了破坏和增殖反应。超出愈合反应的长期严重局部炎症导致血管扩张,可能与极晚期支架血栓形成有关。