Development of a coronary artery aneurysm three months after stent implantation: a case report

Coronary artery stents have been used widely to prevent acute closure as a bailout procedure, or to decrease restenosis after balloon angioplasty. Stent use has increased substantially in recent years due to the ease and simplicity with which stents provide a predictable angiographic result. However, few data exist on the long-term safety of stents. This case report describes a 63-year-old male patient who developed intimal dissection after balloon angioplasty and who underwent coronary stent placement of a sheathed stent (half Palmaz-Schatz stent, 3.5 mm in diameter and 7 mm in length) as a bailout procedure. Postdilatation with a 3.5-mm balloon was performed at the maximum pressure of 14 atmospheres with a satisfactory angiographic result. However, an aneurysmal dilatation at the stent site was noted three months later. High-pressure stent use without immediately visible vascular dissection by angiography may not be effective for prevention of coronary aneurysm development in a case such as this. Aneurysmal dilatation may be a late complication in cases of coronary artery stent placement.