Clinical Outcomes and the Risk Factors of Coronary Artery Aneurysms That Developed After Drug-Eluting Stent Implantation

Abstract

Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp rug-eluting stents (DES) have dramatically reduced the in-stent restenosis (ISR) rates by suppressing neo-intimal hyperplasia. 1,2 However, the complications of DES and safety concerns such as stent thrombosis (ST) have been widely publicized. 3,4 Editorial p 779Another less common complication of DES is coronary artery aneurysm (CAA). CAA is a rare complication after percutaneous coronary intervention (PCI) with the reported rates ranging from 0.3% to 6.0%, and most aneurysms are pseudoaneurysms rather than true aneurysms. 5-8In the DES era, several case reports have been published on the development of CAA after DES implantation 9-12 and 1 reported their incidence to be 1.25%. 13 However, there continues to be scant clinical data on the factors leading to this uncommon complication of DES implantation.The aim of this study is to assess the risk factors and clinical outcomes for CAA that developed after DES implantation by 2 serial angiographic follow-up. Background: There is only limited data on coronary artery aneurysms (CAA) after drug-eluting stent (DES) implantation. Methods Study Population

In Vivo Optical Coherence Tomography of Very Late Drug-Eluting Stent Thrombosis Compared With Late In-Stent Restenosis

“…Of these patients, 14.3% presented with VLST. 24 In another recent study, peri-stent contrast staining, defined as contrast staining outside the stent contour extending to >20% of the stent diameter, was observed in 2.5% of patients after sirolimus-eluting stent implantation on follow-up angiography, and was associated with VLST. 25 Nakagawa concluded that coronary artery aneurysms occur in extreme cases of vessel wall destruction, and relatively milder inflammatory changes are recognized as peri-stent contrast staining on angiography and as late-acquired incomplete stent apposition on intravascular ultrasound or OCT. 26 In the present study, neither coronary artery aneurysm nor peri-stent contrast staining as an angiographic finding were observed in any of the cases of VLST.…”

Speculative Mechanisms for Very Late Stent Thrombosis After Drug-Eluting Stent Implantation

“…3 CAA was identified by coronary angiography in 1.7% of patients, mostly >1 year after DES implantation. In 14.3% patients with CAA, DES implantation was associated with significant clinical stent thrombosis.…”

Clinical outcomes and risk factors of coronary artery aneurysms after successful percutaneous coronary intervention and drug-eluting stent implantation for chronic total occlusions

“…Compared with other etiologies, the formation of CAAs after PCI is relatively rare. The reported incidence of CAAs is 0.3% to 6.0% for PTCA [15][16][17][18], and 0.2% to 10.5% for DES implantation [8,[19][20][21][22][23]. Compared with non-CTOs, our findings showed a slightly high incidence (11.4%) of CAA detection after successful CTO-PCI and DES implantation.…”