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Subclinical very late thrombus formation inside and outside the everolimus-eluting stent implanted 3 years prior in a patient with provoked coronary spasms

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Abstract

A 63-year-old man with non-ST-elevation acute myocardial infarction had undergone PROMUS Element stent implantation for stenosis with thrombus in the left main trunk and the proximal left anterior descending artery. A 6-month follow-up angiography revealed no restenosis or stent thrombosis, but severe provoked spasms in three vessels, for which medications were administered. Three years later, the patient experienced new-onset rest angina one morning. Optical coherence tomography revealed subclinical very late stent thromboses inside and outside the stent. The patients experienced a severe spasm. Platelet function was adequately reduced, and the cytochrome P450 2C19 genotype indicated an extensive metabolizer phenotype. The spasm may have caused the thromboses.

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Authors and Affiliations

  1. Division of Cardiology, Nagoya City East Medical Center, Nagoya, Japan

    Shigenori Ito & Hiroyuki Ohmori

  2. Higashiyama Clinic, The Junshukai Medical Foundation, Nagoya, Japan

    Shigenori Ito

Authors
  1. Shigenori Ito
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  2. Hiroyuki Ohmori
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Correspondence to Shigenori Ito.

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The authors have no financial conflicts of interest to disclose concerning this paper.

Research involving human participants and informed consent

This case study was carried out according to the Declaration of Helsinki. Written informed consent was obtained from the patient for the coronary angiography, PCI, and publication of this case report.

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Ito, S., Ohmori, H. Subclinical very late thrombus formation inside and outside the everolimus-eluting stent implanted 3 years prior in a patient with provoked coronary spasms. Cardiovasc Interv and Ther 32, 72–76 (2017). https://doi.org/10.1007/s12928-015-0372-y

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  • DOI: https://doi.org/10.1007/s12928-015-0372-y

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