Repeat late instent-stenosis after an interval of four years in the same lesion after bare-metal and drug-eluting stent: a case report
© Towae et al; licensee BioMed Central Ltd. 2009
Received: 6 November 2009
Accepted: 31 December 2009
Published: 31 December 2009
In 2001, a 71-year old male was admitted to our hospital with unstable angina. The angiography revealed 2-vessel disease with a 90% stenosis of the proximal LAD. A bare-metal stent was implanted. Four years later the angiography showed a 80% instent-stenosis in the bare-metal stent but no progress at the other coronary arteries. A DES was implanted. Again, four years later, the patient presented with non-ST-elevation myocardial infarction. Angiography showed a 90% instent-restenosis, again without any progession of coronary artery disease in the other vessels. Again a DES implanted. Therefore the processes involved in the late instent-stenosis were not influenced by the antiproliferative agent sirolimus
This case is unusual, because a late instent-stenosis was observed twice without any difference in the time interval of the clinical occurrence of the restenosis between bare-metal and drug-eluting stent [1–3]. Usually restenosis occurs within 6 months after stent implantation. Thereafter the annual restenosis rate is only about 1-2%. In this case, the implantation of a DES did not prolong the time-interval until the restenosis became clinically apparent. Therefore, the processes involved in the late instent-stenosis in this patient were not influenced by the antiproliferative agent sirolimus [4, 5].
Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.
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