Heart Vessels DOI 10.1007/s00380-014-0588-2
CASE REPORT
Preventable effects of bare-metal stent on restenosis after everolimus-eluting stent deployment Akihiro Shirakabe · Masamichi Takano · Masanori Yamamoto · Osamu Kurihara · Nobuaki Kobayashi · Masato Matsushita · Masafumi Tsurumi · Hirotake Okazaki · Noritake Hata · Wataru Shimizu
Received: 19 April 2014 / Accepted: 3 October 2014 © Springer Japan 2014
Abstract This case report describes a patient who underwent implantation of a bare-metal stent (BMS) for the treatment of everolimus-eluting stent (EES) restenosis caused by chronic stent recoil, and the BMS successfully escaped from duplicate restenosis and target lesion revascularization (TLR). Keywords Stent recoil · In-stent restenosis · Target lesion revascularization · Stainless steel stent · Radial force
Introduction First-generation drug-eluting stents (DES), such as sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES), have dramatically reduced the incidence of in-stent restenosis (ISR) in comparison to BMS [1]. However, there are still unresolved problems of late stent thrombosis (LST) [2]. EES, a deputy of second-generation DES reduced ISR rate as well as first-generation DES [3], while their biocompatible polymers were exploited to reduce the occurrence
A. Shirakabe · O. Kurihara · N. Kobayashi · M. Matsushita · M. Tsurumi · H. Okazaki · N. Hata Division of Intensive Care Unit, Chiba-Hokusoh Hospital, Nippon Medical School, 1715 Kamagari, Inzai, Chiba 270-1694, Japan e-mail: [email protected] M. Takano (*) · M. Yamamoto Cardiovascular Center, Chiba-Hokusoh Hospital, Nippon Medical School, 1715 Kamagari, Inzai, Chiba 270-1694, Japan e-mail: [email protected] W. Shimizu Division of Cardiology, Nippon Medical School, Tokyo, Japan
of LST and they really improved the long-term safety and efficacy [4]. Although DES certainly reduced ISR, TLR following ISR of DES (DES-ISR) is required at the rate of 5 % in real world [1, 3]. There are several therapeutic options for DES-ISR: (1) dilatation by a conventional balloon, (2) deployment of BMS, (3) repeated DES implantation (with the same DES or with another DES), (4) use of a drug-eluting balloon or (5) bioresorbable scaffolds [5]. However, the overall recurrent ISR rate was relatively high at approximately 40.0 % [6], and there were still few cases who were treated with BMS for DES-ISR in these patient cohorts [6]. The best treatment for patients with ISR after DES implantation therefore currently remains to be obscure.
Case report A 69-year-old female was admitted to the emergency room with ST-segment depression unstable angina pectoris. The serum level of troponin-T was slightly elevated at 0.03–0 10 ng/ml (normal range
CASE REPORT
Preventable effects of bare-metal stent on restenosis after everolimus-eluting stent deployment Akihiro Shirakabe · Masamichi Takano · Masanori Yamamoto · Osamu Kurihara · Nobuaki Kobayashi · Masato Matsushita · Masafumi Tsurumi · Hirotake Okazaki · Noritake Hata · Wataru Shimizu
Received: 19 April 2014 / Accepted: 3 October 2014 © Springer Japan 2014
Abstract This case report describes a patient who underwent implantation of a bare-metal stent (BMS) for the treatment of everolimus-eluting stent (EES) restenosis caused by chronic stent recoil, and the BMS successfully escaped from duplicate restenosis and target lesion revascularization (TLR). Keywords Stent recoil · In-stent restenosis · Target lesion revascularization · Stainless steel stent · Radial force
Introduction First-generation drug-eluting stents (DES), such as sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES), have dramatically reduced the incidence of in-stent restenosis (ISR) in comparison to BMS [1]. However, there are still unresolved problems of late stent thrombosis (LST) [2]. EES, a deputy of second-generation DES reduced ISR rate as well as first-generation DES [3], while their biocompatible polymers were exploited to reduce the occurrence
A. Shirakabe · O. Kurihara · N. Kobayashi · M. Matsushita · M. Tsurumi · H. Okazaki · N. Hata Division of Intensive Care Unit, Chiba-Hokusoh Hospital, Nippon Medical School, 1715 Kamagari, Inzai, Chiba 270-1694, Japan e-mail: [email protected] M. Takano (*) · M. Yamamoto Cardiovascular Center, Chiba-Hokusoh Hospital, Nippon Medical School, 1715 Kamagari, Inzai, Chiba 270-1694, Japan e-mail: [email protected] W. Shimizu Division of Cardiology, Nippon Medical School, Tokyo, Japan
of LST and they really improved the long-term safety and efficacy [4]. Although DES certainly reduced ISR, TLR following ISR of DES (DES-ISR) is required at the rate of 5 % in real world [1, 3]. There are several therapeutic options for DES-ISR: (1) dilatation by a conventional balloon, (2) deployment of BMS, (3) repeated DES implantation (with the same DES or with another DES), (4) use of a drug-eluting balloon or (5) bioresorbable scaffolds [5]. However, the overall recurrent ISR rate was relatively high at approximately 40.0 % [6], and there were still few cases who were treated with BMS for DES-ISR in these patient cohorts [6]. The best treatment for patients with ISR after DES implantation therefore currently remains to be obscure.
Case report A 69-year-old female was admitted to the emergency room with ST-segment depression unstable angina pectoris. The serum level of troponin-T was slightly elevated at 0.03–0 10 ng/ml (normal range
