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Right coronary artery 'diverticulosis' 4 years after sirolimus-eluting stent implantation associated with very late stent thrombosis



Right coronary artery 'diverticulosis' 4 years after sirolimus-eluting stent implantation associated with very late stent thrombosis



Heart 99(21): 1627



A 55-year-old female patient with diabetes was admitted with an acute inferior ST-elevation myocardial infarction. Three years previously, she had undergone elective percutaneous coronary intervention to the proximal and mid-segments of her right coronary artery (RCA) (A) with two overlapping sirolimus-eluting stents (Cypher Select Plus 2.75x33 mm and 3.0x33 mm). Figure 1Angiography (A–D) and frequency domain optical coherence tomography (FD-OCT) (E and F) images of the right coronary artery including: (A) after sirolimus-eluting stent implantation, (B) following presentation with thrombotic occlusion, (C) post-recanalisation with marked outpouchings in the proximal vessel, (D) post-intervention with everolimus-eluting stents highlighting (yellow arrowheads) residual outpouchings corresponding to the FD-OCT images, (E) evaginations (maximum 0.4 mm) at the site of initial mid-vessel occlusion and (F) multiple large (maximum 1.4 mm) proximal evaginations. Emergency coronary angiography revealed a thrombotic occlusion of the previous RCA stents (B). Following aspiration thrombectomy, angiography revealed residual thrombus and moderate in-stent.

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Accession: 036925818

Download citation: RISBibTeXText

PMID: 23749781

DOI: 10.1136/heartjnl-2013-304263


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