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Updated: Jul 18, 2026
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Revascularization of malignant coronary instent restenosis resulting from Takayasu's arteritis using
Hidetsugu Sakai1, Naotsugu Oyama, Noriaki Kishimoto
1Division of Cardiology, Kushiro Rosai Hospital, Hokkaido, Japan.
Insights
This case study shows sirolimus-eluting stents effectively treated severe left main coronary artery stenosis in a patient with arteritis. The culottes stenting technique provided a lasting solution after multiple prior interventions.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Surgery
Background:
- A 37-year-old female with a 20-year history of arteritis underwent a Bentall operation.
- Post-operatively, she developed severe left main coronary artery (LMCA) stenosis, necessitating a minimally invasive direct coronary artery bypass (MIDCAB) operation.
Observation:
- The patient experienced recurrent angina 6 months after MIDCAB due to left internal thoracic artery graft occlusion.
- Multiple stent placements in the LMCA were required due to persistent stenosis, with 8 reinterventions over 3 months.
Findings:
- Two sirolimus-eluting stents were successfully deployed in the LMCA using the culottes stenting technique.
- Six-month follow-up coronary angiography revealed no residual stenosis in the LMCA.
Implications:
- Sirolimus-eluting stents, applied via the culottes technique, demonstrate efficacy in managing complex LMCA stenosis.
- This approach is effective for stenosis arising from both arteritis and atherosclerosis, offering a durable solution.
Abstract:
A 37 year-old female who had suffered from arteritis for 20 years underwent a Bentall operation. Since severe stenosis was observed in her left main coronary artery (LMCA) the following year, a minimally invasive direct coronary artery bypass (MIDCAB) operation was performed. Unfortunately, she again complained of angina about 6 months after the second surgery and coronary angiography (CAG) revealed that her left internal thoracic artery graft was totally occluded. Although a 4.0 x 15 mm S670 stent was placed in her LMCA, the LMCA re-stented every 3 months and she underwent reintervention 8 times. We placed 2 sirolimus-eluting stents for treating the LMCA using the culottes stenting technique. CAG 6 months after the index procedure showed no stenosis at her LMCA. Sirolimus-eluting stents were effective for treating stenosis resulting from arteritis as well as that caused by atherosclerosis.
