Heterogeneous Intravascular Ultrasound Findings of Stent Thrombosis
| Autor: | Takumi Sumimoto, Haruhiko Higashi, Shinji Inaba, Kayo Takahashi, Makoto Saito, Hiroe Aisu, Toyofumi Yoshii, Toru Morofuji |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Dissection (medical) 030204 cardiovascular system & hematology bare-metal stent Coronary Angiography intravascular ultrasound 03 medical and health sciences 0302 clinical medicine Japan Antithrombotic Intravascular ultrasound Internal Medicine medicine drug-eluting stent Stent implantation Humans In patient 030212 general & internal medicine Stent thrombosis cardiovascular diseases Ultrasonography Interventional Aged Retrospective Studies Neointimal hyperplasia stent thrombosis Aged 80 and over Sirolimus medicine.diagnostic_test business.industry Coronary Thrombosis Stent Drug-Eluting Stents General Medicine Middle Aged medicine.disease equipment and supplies Prosthesis Failure surgical procedures operative Original Article Female Radiology business |
| Zdroj: | Internal Medicine |
| ISSN: | 1349-7235 0918-2918 |
| Popis: | Objective The underlying mechanisms of stent thrombosis are not completely understood. Methods We experienced 12 definite stent thrombosis cases (1 early, 1 late, and 10 very late) at our hospital from July 2011 to April 2016 and evaluated the possible causes of stent thrombosis by intravascular ultrasound (IVUS). Results Five different potential morphological causes of stent thrombosis (neoatherosclerosis, stent malapposition, stent fracture, edge dissection, and stent underexpansion) were detected by IVUS in 10 cases (83.3%); in 1 of the remaining 2 cases, the discontinuation of antithrombotic drugs resulted in early stent thrombosis without abnormal IVUS findings. Of the 12 stent thrombosis cases, 4 occurred at a bare-metal stent (average time from stent implantation, 106 months); in all 12, significant neointimal hyperplasia was observed on IVUS, and 2 had plaque ruptures at an in-stent or proximal reference. Malapposed stent struts were observed in three very-late stent thromboses, and all of these underwent sirolimus-eluting stent implantation. Stent thrombosis due to mechanical (stent fracture) or procedure-related complications (edge dissection and stent underexpansion) was observed in three cases. Conclusion In patients with stent thrombosis, heterogeneous findings were observed in IVUS. This IVUS case series illustrates the possible mechanisms of stent thrombosis. |
| Databáze: | OpenAIRE |
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