Author + information
- Received July 22, 2010
- Revision received September 10, 2010
- Accepted September 17, 2010
- Published online April 1, 2011.
- Masamichi Takano, MD⁎,⁎ (, )
- Masanori Yamamoto, MD⁎,
- Toru Inami, MD⁎,
- Daisuke Murakami, MD⁎,
- Yoshihiko Seino, MD⁎ and
- Kyoichi Mizuno, MD†
- ↵⁎Reprint requests and correspondence:
Dr. Masamichi Takano, Cardiovascular Center, Chiba-Hokusoh Hospital, Nippon Medical School, 1715 Kamakari, Inzai, Chiba 270–1694, Japan
A polytetrafluoroethylene (PTFE)-covered stent composed of 2 metallic stents and sandwiched PTFE membrane is specially used for bailout of percutaneous intervention complicated with coronary perforation and treatment of aneurysms to prevent subsequent rupture. Detailed features within coronary stent grafts have not yet been reported in living patients. A 65-year-old man underwent PTFE-covered stent (3.5/19 mm) deployment to seal a giant aneurysm in the right coronary artery. Follow-up angiography at 32 months showed patency and slightly irregular contour of the stent segment. Coronary angioscopy showed sufficient neointimal growth at the stent proximal edge. Several struts in the mid portion were regarded as exposed struts lacking neointimal coverage. Red thrombi were found in the distal portion despite continuous oral anticoagulation and dual antiplatelet therapies (Fig. 1, Online Video 1). Optical coherence tomography confirmed the presence of uncovered struts as well as thrombus formation (Fig. 2). Pathological validation using light and electron microscopy has demonstrated incomplete endothelialization and accumulation of fibrin clots within endovascular stent grafts deployed for aortic aneurysms (1). The current intracoronary images suggest that delayed healing and thrombogenicity of coronary stent graft persists for an extended period.
For an accompanying video, please see the online version of this article.
The authors have reported that they have no relationships to disclose.
- Received July 22, 2010.
- Revision received September 10, 2010.
- Accepted September 17, 2010.
- American College of Cardiology Foundation