Subclinical very late thrombus formation inside and outside the everolimus-eluting stent implanted 3 years prior in a patient with provoked coronary spasms

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• 作者：Shigenori Ito ; Hiroyuki Ohmori
• 关键词：Coronary spasm ; Drug ; eluting stent ; Everolimus ; Acetylcholine ; Late stent thrombosis ; Acute coronary syndrome
• 刊名：Cardiovascular Intervention and Therapeutics
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：32
• 期：1
• 页码：72-76
• 全文大小：
• 刊物主题：Cardiology; Interventional Radiology;
• 出版者：Springer Japan
• ISSN：1868-4297
• 卷排序：32

文摘

A 63-year-old man with non-ST-elevation acute myocardial infarction had undergone PROMUS Element stent implantation for stenosis with thrombus in the left main trunk and the proximal left anterior descending artery. A 6-month follow-up angiography revealed no restenosis or stent thrombosis, but severe provoked spasms in three vessels, for which medications were administered. Three years later, the patient experienced new-onset rest angina one morning. Optical coherence tomography revealed subclinical very late stent thromboses inside and outside the stent. The patients experienced a severe spasm. Platelet function was adequately reduced, and the cytochrome P450 2C19 genotype indicated an extensive metabolizer phenotype. The spasm may have caused the thromboses.