ID 109760
Title Transcription
シロリムス ヨウシュツ ステント リュウチ 7ネンゴ ニ ハジメテ ゾウエイザイ ステント シュウイ シミダシゾウ オ ミトメタ イチレイ
Title Alternative
A case report of late acquired peri-stent contrast staining seven years after sirolimuseluting stent implantation
Author
Matsumoto, Kazuhisa The Post-graduate Education Center, Tokushima University Hospital
Takashima, Akira Department of Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School
Yamaguchi, Koji Department of Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Wakatsuki, Tetsuzo Department of Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Saijo, Yoshihito Department of Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School
Takagi, Eri Department of Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School
Hara, Tomoya Department of Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School
Saito, Yuko Department of Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School
Ogasawara, Kozue Department of Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School
Bando, Mika Department of Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Bando, Sachiko Department of Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School
Matsuura, Tomomi Department of Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Ise, Takayuki Department of Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Hotchi, Junko Department of Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School
Kimura, Eriko Department of Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School
Tobiume, Takeshi Department of Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Yagi, Shusuke Department of Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Iwase, Takashi Department of Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School KAKEN Search Researchers
Yamada, Hirotsugu Department of Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Soeki, Takeshi Department of Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Sata, Masataka Department of Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Keywords
coagulation
dual antiplatelet therapy
peri-stent contrast staining
sirolimus eluting stent
very late stent thrombosis
Content Type
Journal Article
Description
A 74-year-old man who had a history of percutaneous coronary intervention [left anterior descending coronary artery #6‐7, sirolimus eluting stent (SES) (Cypher stent,3.0×18mm), left circumflex coronary artery #13, SES (Cypher stent, 2.5×23mm)] for angina pectoris experienced chest pain on effort after seven years from the coronary intervention. He was introduced to our hospital and coronary angiography revealed late acquired peri-stent contrast staining (PSS), which is defined as an angiographical finding of contrast medium stain outside the stent being >20% of the stent diameter, in the SES of the left anterior descending artery.
Drug-eluting stent (DES) significantly inhibits neointimal proliferation, thereby significantly reducing in-stent restenosis. However, the risk of very late stent thrombosis has become a major problem after the DES implantation against the bare-metal stent implantation.
PSS has been reported that PSS after SES implantation could predict late stent thrombosis and incomplete stent apposition of the lesion with PSS.
In this case, PSS was pointed out for the first time in seven years after SES implantation nevertheless it did not be pointed out in three years. The mechanism and prognosis of PSS is unclear. But, we found the increase in local coagulation at the coronary artery in this case and the degree of prothrombin fragment F1+2, one of the coagulation marker, was greater in seven years after SES implantation than in three years. We thought these findings might reflect that PSS after SES implantation was associated with very late stent thrombosis. So we started the dual antiplatelet therapy for the prevention of stent thrombosis.
Careful long-term observation might be recommended in patients with late acquired PSS and elevated local coagulation response following SES implantation.
Journal Title
四国医学雑誌
ISSN
00373699
NCID
AN00102041
Publisher
徳島医学会
Volume
70
Issue
3-4
Start Page
93
End Page
98
Sort Key
93
Published Date
2014-08-25
FullText File
language
jpn
TextVersion
Publisher
departments
University Hospital
Medical Sciences