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[Coronary artery aneurysm one year and five months after sirolimus-eluting stent placement]
Luciano Abreu1, George César Ximenes Meireles, Antonio Artur Forte
1Departamento de Cardiologia, Hospital Stella Maris, São Paulo, SP.
Insights
Sirolimus-eluting stents may lead to late-forming coronary artery aneurysms. This case report highlights a potential long-term complication of sirolimus-coated coronary stent implantation.
Area of Science:
- Cardiology
- Interventional Cardiology
- Biomedical Engineering
Background:
- Post-infarction unstable angina requires intervention.
- Coronary artery disease necessitates revascularization procedures.
- Drug-eluting stents are commonly used to treat coronary lesions.
Observation:
- A 52-year-old man with unstable angina underwent stenting.
- A sirolimus-eluting stent was implanted in the left marginal branch.
- Follow-up angiography revealed an intrastent coronary aneurysm.
Findings:
- Intrastent coronary aneurysm formation occurred 1.5 years post-stenting.
- The sirolimus-coated stent (CYPHER) was implicated in aneurysm development.
- This suggests a potential late adverse effect of sirolimus-eluting stents.
Implications:
- Coronary artery aneurysm is a potential complication of sirolimus-eluting stents.
- Long-term surveillance may be necessary after sirolimus-eluting stent implantation.
- Further research is needed to understand the mechanism and incidence of stent-related aneurysms.
Abstract:
A 52-year-old man with diagnosis of post-infarction unstable angina. Coronary angiography revealed 90% luminal obstruction in the middle third of the right coronary artery and 90% in the marginal branch of the circumflex artery. After the administration of clopidogrel 300 mg associated with acetylsalicylic acid, the patient underwent the implantation of a sirolimus-eluting stent (CYPHER; Johnson & Johnson--Cordis) 2.5 x 1.8 mm in the lesion located at the left marginal branch. One year and five months after the CYPHER stent implantation, a new angiography showed intrastent coronary aneurysm at the left marginal branch. This case report suggests that the implantation of a sirolimus-coated coronary stent may cause late formation of coronary artery aneurysm.
