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Optical coherence tomography visualization of stent deformation with subsequent thrombus adhesion at very early phase after everolimus-eluting stent implantation: a case report
BACKGROUND: Stent malapposition, stent fracture, and deformity, and inadequate anti-thrombotic therapy are known as the risk of stent thrombosis. We report a case of stent deformation with subsequent thrombus adhesion at the site of a partial stent fracture detected by intravascular ultrasound (IVUS...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4886434/ https://www.ncbi.nlm.nih.gov/pubmed/27245071 http://dx.doi.org/10.1186/s12872-016-0295-2 |
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author | Yamamura, Satoru Fujisue, Koichiro Tsujita, Kenichi Sakamoto, Kenji Miyazaki, Yuji Kaikita, Koichi Hokimoto, Seiji Ogawa, Hisao |
author_facet | Yamamura, Satoru Fujisue, Koichiro Tsujita, Kenichi Sakamoto, Kenji Miyazaki, Yuji Kaikita, Koichi Hokimoto, Seiji Ogawa, Hisao |
author_sort | Yamamura, Satoru |
collection | PubMed |
description | BACKGROUND: Stent malapposition, stent fracture, and deformity, and inadequate anti-thrombotic therapy are known as the risk of stent thrombosis. We report a case of stent deformation with subsequent thrombus adhesion at the site of a partial stent fracture detected by intravascular ultrasound (IVUS) and optical coherence tomography (OCT). CASE PRESENTATION: A 61-year-old male patient was diagnosed as effort angina pectoris. Coronary angiography revealed obstructions in the proximal segment of the left anterior descending (LAD) and left circumflex artery (LCx). Elective percutaneous coronary intervention (PCI) was scheduled for these lesions in the prior hospital. First, an everolimus-eluting stent (EES) was implanted in the just proximal LAD slightly protruding into left main trunk. One week later, the treatment to residual obstruction at proximal LCx was attempted. During delivery of the stent to LCx, the proximal edge of the previously-implanted LAD stent got stuck with the newly-deploying stent and deformed into the intravascular lumen when retracting the stent into the guide-catheter. He was immediately transferred to our hospital to repair these procedural problems. Two days later after the index procedure to LCx, intracoronary imaging with an IVUS and OCT were performed, and the IVUS/OCT imaging revealed thrombus adhesion around the deformed struts. The three-dimensional OCT guide also helped the detection of the deformed stent and the repair of deformed struts by additional stenting and kissing balloon technique. CONCLUSION: The current case suggested that thrombus adhesion can occur at the site of deformed and/or fractured stent at very early phase after stent implantation. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12872-016-0295-2) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-4886434 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-48864342016-06-01 Optical coherence tomography visualization of stent deformation with subsequent thrombus adhesion at very early phase after everolimus-eluting stent implantation: a case report Yamamura, Satoru Fujisue, Koichiro Tsujita, Kenichi Sakamoto, Kenji Miyazaki, Yuji Kaikita, Koichi Hokimoto, Seiji Ogawa, Hisao BMC Cardiovasc Disord Case Report BACKGROUND: Stent malapposition, stent fracture, and deformity, and inadequate anti-thrombotic therapy are known as the risk of stent thrombosis. We report a case of stent deformation with subsequent thrombus adhesion at the site of a partial stent fracture detected by intravascular ultrasound (IVUS) and optical coherence tomography (OCT). CASE PRESENTATION: A 61-year-old male patient was diagnosed as effort angina pectoris. Coronary angiography revealed obstructions in the proximal segment of the left anterior descending (LAD) and left circumflex artery (LCx). Elective percutaneous coronary intervention (PCI) was scheduled for these lesions in the prior hospital. First, an everolimus-eluting stent (EES) was implanted in the just proximal LAD slightly protruding into left main trunk. One week later, the treatment to residual obstruction at proximal LCx was attempted. During delivery of the stent to LCx, the proximal edge of the previously-implanted LAD stent got stuck with the newly-deploying stent and deformed into the intravascular lumen when retracting the stent into the guide-catheter. He was immediately transferred to our hospital to repair these procedural problems. Two days later after the index procedure to LCx, intracoronary imaging with an IVUS and OCT were performed, and the IVUS/OCT imaging revealed thrombus adhesion around the deformed struts. The three-dimensional OCT guide also helped the detection of the deformed stent and the repair of deformed struts by additional stenting and kissing balloon technique. CONCLUSION: The current case suggested that thrombus adhesion can occur at the site of deformed and/or fractured stent at very early phase after stent implantation. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12872-016-0295-2) contains supplementary material, which is available to authorized users. BioMed Central 2016-05-31 /pmc/articles/PMC4886434/ /pubmed/27245071 http://dx.doi.org/10.1186/s12872-016-0295-2 Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Case Report Yamamura, Satoru Fujisue, Koichiro Tsujita, Kenichi Sakamoto, Kenji Miyazaki, Yuji Kaikita, Koichi Hokimoto, Seiji Ogawa, Hisao Optical coherence tomography visualization of stent deformation with subsequent thrombus adhesion at very early phase after everolimus-eluting stent implantation: a case report |
title | Optical coherence tomography visualization of stent deformation with subsequent thrombus adhesion at very early phase after everolimus-eluting stent implantation: a case report |
title_full | Optical coherence tomography visualization of stent deformation with subsequent thrombus adhesion at very early phase after everolimus-eluting stent implantation: a case report |
title_fullStr | Optical coherence tomography visualization of stent deformation with subsequent thrombus adhesion at very early phase after everolimus-eluting stent implantation: a case report |
title_full_unstemmed | Optical coherence tomography visualization of stent deformation with subsequent thrombus adhesion at very early phase after everolimus-eluting stent implantation: a case report |
title_short | Optical coherence tomography visualization of stent deformation with subsequent thrombus adhesion at very early phase after everolimus-eluting stent implantation: a case report |
title_sort | optical coherence tomography visualization of stent deformation with subsequent thrombus adhesion at very early phase after everolimus-eluting stent implantation: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4886434/ https://www.ncbi.nlm.nih.gov/pubmed/27245071 http://dx.doi.org/10.1186/s12872-016-0295-2 |
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