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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...

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Autores principales: Yamamura, Satoru, Fujisue, Koichiro, Tsujita, Kenichi, Sakamoto, Kenji, Miyazaki, Yuji, Kaikita, Koichi, Hokimoto, Seiji, Ogawa, Hisao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
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.
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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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