Long drug-eluting stent implantation for a diffusely diseased right internal mammary artery

The frequent use of the internal mammary artery as a bypass graft has brought about an increasing need for angioplasty to treat stenotic arterial grafts. Percutaneous interventions of internal mammary artery grafts by balloon angioplasty or stenting with bare-metal stents have been described in the past. However, implantation of bare-metal stents was associated with high rates of restenosis. The introduction of drug-eluting stents for the treatment of diseased native coronary vessels has been associated with a reduced need for repeat intervention compared with bare-metal stents for both low-risk lesions and high-risk, complex lesions, including the 'long lesion' subset. We describe a case of long drug-eluting stent implantation for a diffusely diseased right internal mammary artery.