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A case report of very late stent thrombosis with peri-stent coronary artery aneurysm and stent-related coronary vasospasm

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Abstract

We describe a 42-year-old man with very late stent thrombosis (VLST) 35 months after implantation of a sirolimus-eluting stent (SES). Three months after the VLST episode, a follow-up angiography showed a formation of peri-stent coronary artery aneurysm. Sixty-five months after SES implantation, the patient suffered an out-of-hospital cardiac arrest. We performed spasm provocation test using acetylcholine to evaluate coronary vasomotor response and the coronary segments adjacent to the SES showed significant vasoconstriction. Intracoronary pretreatment of Rho-kinase inhibitor, fasudil, markedly attenuated acetylcholine-induced vasoconstriction. This report documents a unique case suffering from multiple fatal complications after SES implantation.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, International University of Health and Welfare Hospital, Nasushiobara, Japan

    Morihiko Takeda & Nobuyuki Shiba

  2. Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan

    Morihiko Takeda, Jun Takahashi & Hiroaki Shimokawa

Authors
  1. Morihiko Takeda
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  2. Nobuyuki Shiba
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  3. Jun Takahashi
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  4. Hiroaki Shimokawa
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Correspondence to Morihiko Takeda.

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Takeda, M., Shiba, N., Takahashi, J. et al. A case report of very late stent thrombosis with peri-stent coronary artery aneurysm and stent-related coronary vasospasm. Cardiovasc Interv and Ther 28, 272–278 (2013). https://doi.org/10.1007/s12928-012-0155-7

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  • DOI: https://doi.org/10.1007/s12928-012-0155-7

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