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Cardiovascular Intervention and Therapeutics

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01-04-2014 | Case Report

A case report of very late stent thrombosis observed simultaneously in all three vessels 5 years after sirolimus-eluting stent implantation

Authors: Shigefumi Fukui, Hideaki Endo, Sota Nakajima, Tohru Takahashi, Akihiro Nakamura, Eiji Nozaki

Published in: Cardiovascular Intervention and Therapeutics | Issue 2/2014

Abstract

A 67-year-old man with recent myocardial infarction underwent a total of five sirolimus-eluting stents (SES) implantation for three vessels stage by stage. A follow-up angiography showed no significant restenosis except one in the side branch. Thereafter, he had remained asymptomatic. Sixty-six months later, he had an acute myocardial infarction with cardiogenic shock due to simultaneous 3-vessel very late stent thrombosis (VLST). After successful percutaneous coronary intervention, final angiography revealed serious peri-stent contrast staining along with positive remodeling and grade V stent fracture. This rare case illustrates simultaneous 3-vessel VLST, associating with multiple SES-related problems, under continuation of aspirin and cilostazol.

Moses JW, Leon MB, Popma JJ, Fitzgerald PJ, Holmes DR, O’Shaughnessy C, et al. Sirolimus-eluting stents versus standard stents in patients with stenosis in a native coronary artery. N Engl J Med. 2003;349:1315–23.PubMedCrossRef

Colombo A, Moses JW, Morice MC, Ludwig J, Holmes DR Jr, Spanos V, et al. Randomized study to evaluate sirolimus-eluting stents implanted at coronary bifurcation lesions. Circulation. 2004;109:1244–9.PubMedCrossRef

Gaku N, Kengo T, Aoki J, Onuma Y, Yamamoto H, Higashikuni Y, et al. Clinical and angiographic outcomes of sirolimus-eluting stents implantation in Japanese patients in daily practice. Circ J. 2006;70:1367–71.PubMedCrossRef

Kastrati A, Mehilli J, Pache J, Kaiser C, Valgimigli M, Kelbaek H, et al. Analysis of 14 trials comparing sirolimus-eluting stents with bare-metal stents. N Engl J Med. 2007;356:1030–9.PubMedCrossRef

Camenzind E, Steg PG, Wijns W. Stent thrombosis late after implantation of first-generation drug-eluting stents: a cause for concern. Circulation. 2007;115:1440–55.PubMedCrossRef

Kimura T, Morimoto T, Kozuma K, Honda Y, Kume T, Aizawa T, et al. Comparisons of baseline demographics, clinical presentation, and long-term outcome among patients with early, late, and very late stent thrombosis of sirolimus-eluting stents: observations from the Registry of Stent Thrombosis for Review and Reevaluation (RESTART). Circulation. 2010;122:52–61.PubMedCrossRef

Kimura T, Morimoto T, Nakagawa Y, Kawai K, Miyazaki S, Muramatsu T, et al. Very late stent thrombosis and late target lesion revascularization after sirolimus-eluting stent implantation: 5-year outcome of the j-Cypher Registry. Circulation. 2012;125:584–91.PubMedCrossRef

Hofma SH, van der Giessen WJ, van Dalen BM, Lemos PA, McFadden EP, Sianos G, et al. Indication of long-term endothelial dysfunction after sirolimus-eluting stent implantation. Eur Heart J. 2006;27:166–70.PubMedCrossRef

Brott BC, Anayiotos AS, Chapman GD, Anderson PG, Hillegass WB. Severe, diffuse coronary artery spasm after drug-eluting stent placement. J Invasive Cardiol. 2006;18:584–92.PubMed

10.

Takeda M, Shiba N, Takahashi J, Shimokawa H. A case report of very late stent thrombosis with peri-stent coronary artery aneurysm and stent-related coronary vasospasm. Cardiovasc Interv Ther. 2013;28:272–8.PubMedCrossRef

11.

Imai M, Kadota K, Goto T, Fujii S, Yamamoto H, Fuku Y, et al. Incidence, risk factors, and clinical sequelae of angiographic peri-stent contrast staining after sirolimus-eluting stent implantation. Circulation. 2011;123:2382–91.PubMedCrossRef

12.

Cook S, Ladich E, Nakazawa G, Eshtehardi P, Neidhart M, Vogel R, et al. Correlation of intravascular ultrasound findings with histopathological analysis of thrombus aspirates in patients with very late drug-eluting stent thrombosis. Circulation. 2009;120:391–9.PubMedCrossRef

13.

Virmani R, Guagliumi G, Farb A, Musumeci G, Grieco N, Motta T, et al. Localized hypersensitivity and late coronary thrombosis secondary to a sirolimus-eluting stent: should we be cautious? Circulation. 2004;109:701–5.PubMedCrossRef

14.

Kon H, Sakai H, Otsubo M, Takano H, Okamoto K, Sato T, et al. Contrast staining outside the sirolimus-eluting stent leading to coronary aneurysm formation: a case of very late stent thrombosis associated with hypersensitivity reaction. Circ Cardiovasc Interv. 2011;4:e1–3.PubMedCrossRef

15.

Mabuchi T, Fujino S, Yamaguchi M, Noji Y, Ichise T, Aoyama T. Very late stent thrombosis after sirolimus-eluting stent implantation: evaluation by intravascular ultrasound and optical coherence tomography. Cardiovasc Interv Ther. 2013, in press.

16.

Lee JS, Dunn SP, Marshall HM, Cohen MG, Smyth SS. A case report of simultaneous thrombosis of two coronary artery stents in association with clopidogrel resistance. Clin Cardiol. 2007;30:200–3.PubMedCrossRef

17.

Cola C, Brugaletta S, Martin Yuste V, Campos B, Angiolillo DJ, Sabate M. Diabetes mellitus: a prothrombotic state implications for outcomes after coronary revascularization. Vasc Health Risk Manag. 2009;5:101–19.PubMedCentralPubMedCrossRef

18.

Lee JM, Yoon CH. Acute coronary stent thrombosis in cancer patients: a case series report. Korean Circ J. 2004;42:487–91.CrossRef

19.

Lee SW, Park SW, Hong MK, Kim YH, Lee BK, Song JM, et al. Triple versus dual antiplatelet therapy after coronary stenting: impact on stent thrombosis. J Am Coll Cardiol. 2005;46:1833–7.PubMedCrossRef

20.

Kimura T, Morimoto T, Nakagawa Y, Kadota K, Nozaki Y, Tada T, et al. Antiplatelet therapy and long-term clinical outcome after sirolimus-eluting stent implantation: 5-year outcome of the j-Cypher registry. Cardiovasc Interv Ther. 2012;27:181–8.PubMedCrossRef

21.

Fujiwara T, Sakakura K, Ako J, Wada H, Arao K, Sugawara Y, et al. Occurrence of late acquired peri-stent contrast staining: comparison between sirolimus-eluting stents and everolimus-eluting stents. Int Heart J. 2012;53:165–9.PubMedCrossRef

Title: A case report of very late stent thrombosis observed simultaneously in all three vessels 5 years after sirolimus-eluting stent implantation
Authors: Shigefumi Fukui
Hideaki Endo
Sota Nakajima
Tohru Takahashi
Akihiro Nakamura
Eiji Nozaki
Publication date: 01-04-2014
Publisher: Springer Japan
Published in: Cardiovascular Intervention and Therapeutics / Issue 2/2014
Print ISSN: 1868-4300
Electronic ISSN: 1868-4297
DOI: https://doi.org/10.1007/s12928-013-0201-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A case report of very late stent thrombosis observed simultaneously in all three vessels 5 years after sirolimus-eluting stent implantation

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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