Author + information
- Received August 10, 2011
- Accepted September 3, 2011
- Published online March 1, 2012.
- ↵⁎Reprint requests and correspondence:
Dr. Yoshihide Fujimoto, Department of Cardiovascular Science and Medicine, Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba 260–8677, Japan
A 76-year-old man with 80% and 90% stenosis with severe calcification in the proximal and mid-right coronary artery (RCA), respectively (Figs. 1A and 1B), was referred for coronary angioplasty. After rotational atherectomy and balloon inflation, a 23-mm everolimus-eluting stent was deployed in the proximal RCA. Delivery of a 14-mm biolimus-eluting stent (Nobori, Terumo Corporation, Tokyo, Japan) with abluminal biodegradable polymer in the mid-RCA was attempted. It passed through the everolimus-eluting stent in the proximal RCA without difficulty. However, it would not advance to the target lesion in the mid-RCA (Fig. 1C). Additional balloon inflation was performed. A 12-mm Driver Sprint stent (Medtronic, Minneapolis, Minnesota) was then deployed in the mid-RCA. The final angiogram showed a good result (Fig. 1D). Scanning electron microscopy demonstrated damage to the polymer of the biolimus-eluting stent; most of the damage was delamination of abluminal polymer (Figs. 2A to 2D).
The Nobori stent has biodegradable polymer (poly-lactic acid) containing biolimus A9 that is coated only on the abluminal stent surface. Compared with polymer around stent struts, delamination of abluminal polymer might occur more easily when it is delivered through a calcified coronary artery.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received August 10, 2011.
- Accepted September 3, 2011.
- American College of Cardiology Foundation