Author + information
- Received January 2, 2014
- Accepted January 4, 2014
- Published online March 1, 2014.
- Girish N. Viswanathan, MBBS, MD∗,
- Saqib Chowdhary, MBBS, PhD† and
- Richard A. Anderson, BSc, MBBS, MD‡∗ ()
- ∗Royal Bournemouth Hospital, Dorset, United Kingdom
- †University Hospital of South Manchester, Manchester, United Kingdom
- ‡University Hospital of Wales, Cardiff, United Kingdom
- ↵∗Reprint requests and correspondence:
Dr. Richard Anderson, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, United Kingdom.
- coronary artery aneurysm
- coronary stent(s)
- optical coherence tomography
- percutaneous coronary intervention
We earlier reported late stent malapposition and marked coronary artery aneurysm (CAN) formation at the site of implantation of 2 bare-metal stents (BMS), Multilink Vision (Abbott Laboratories, Abbott Park, Illinois) and Liberte (Boston Scientific Corporation, Natick, Massachusetts), to the proximal left anterior descending artery (LAD) and right coronary artery (RCA), respectively, in a woman treated for stable angina in 2006. The patient also had a Xience drug-eluting stent (DES) (Abbott Laboratories) to her mid RCA with less marked CAN on angiography in 2007 (1). Diagnostic coronary angiography and optical coherence tomography (OCT) assessment was performed in 2012, although she remained free of symptoms or hospitalizations. Five years later, coronary angiography showed partial angiographic resolution of the CAN in the 2 BMS segments, with continued aneurysm formation at the Xience DES implantation site (Online Video 1 from 2007 and Online Videos 2, 3 and 4 from 2012).
OCT showed nearly complete tissue coverage of former CAN segments in the LAD BMS with a heterogeneous banded appearance of the neointima in places. A small residual CAN persists with partial strut coverage (Figs. 1E and 1F). Figure 1G shows a more advanced healing of the BMS to the RCA, with complete resolution of the CAN and a more homogeneous appearance of the complete covering of neointima. However, the DES to the RCA segment shows persistence of the large acquired CAN. There is a tissue covering that partially bridges the grossly malapposed struts and is continuous with the neointima of the apposed stent segments (despite nonapposition distances of up to 2 mm from the vessel wall).
These novel BMS findings have not been reported previously and serve to illustrate the OCT appearances associated with healing of a CAN.
For supplementary videos and their legends, please see the online version of this article.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received January 2, 2014.
- Accepted January 4, 2014.
- American College of Cardiology Foundation