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A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
04:30

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis

Published on: May 14, 2013

Drug-eluting stent as an option for intractable in-stent coronary restenosis

Daisuke Hachinohe1, Myung Ho Jeong, Min Chol Kim

  • 1The Heart Center of Sapporo Higashi Tokushukai Hospital, Sapporo, Japan.

Korean Circulation Journal
|December 24, 2011
PubMed

Insights

This case study highlights a patient with recurrent in-stent restenosis after bare-metal stent implantation. A final sirolimus-eluting stent successfully resolved the issue, preventing further restenosis and symptoms.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Biomedical Engineering

Background:

  • Recurrent in-stent restenosis (ISR) poses a significant challenge after percutaneous coronary intervention (PCI).
  • Bare-metal stents (BMS) have a higher risk of ISR compared to drug-eluting stents.
  • Managing complex ISR cases requires tailored therapeutic strategies.

Purpose of the Study:

  • To describe the management of a patient with multiple episodes of in-stent restenosis (ISR) following bare-metal stent (BMS) implantation.
  • To evaluate the effectiveness of various treatment modalities for recurrent ISR.
  • To demonstrate the successful outcome of sirolimus-eluting stent implantation in a refractory ISR case.

Main Methods:

  • A 51-year-old male patient with acute anterior ST-elevation myocardial infarction (STEMI) underwent BMS implantation in the left anterior descending artery (LAD).
  • The patient experienced five episodes of ISR, treated sequentially with plain old balloon angioplasty (POBA), brachytherapy, and additional BMS.
  • The fifth ISR episode was treated with a sirolimus-eluting stent (SES).

Main Results:

  • The patient suffered five distinct episodes of in-stent restenosis (ISR) after initial BMS implantation.
  • Sequential treatments including POBA, brachytherapy, and additional BMS failed to provide long-term resolution.
  • Implantation of a sirolimus-eluting stent (SES) at the fifth ISR episode resulted in complete resolution of restenosis.
  • The patient remained asymptomatic with no ISR on follow-up coronary angiography after SES implantation.

Conclusions:

  • Sirolimus-eluting stents are highly effective in treating complex and recurrent in-stent restenosis (ISR) cases.
  • Management of refractory ISR may require escalation of treatment strategies.
  • Successful SES implantation can lead to long-term freedom from restenosis and symptoms.

Keywords:
AngioplastyBrachytherapyCoronary restenosisDrug-eluting stents

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