Drug-Eluting Stent (DES) Induced Coronary Artery Aneurysm - A Case Report.
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Date
2013
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Abstract
Drug-eluting stents (DES), which locally elute antiproliferative drugs, can dramatically inhibit neointimal
growth. However, several pathological studies have indicated that DES may delay healing after vascular
injury, and DES implantation may be theoretically associated with a risk of coronary artery aneurysm
formation. Coronary aneurysms have been reported from 3 days to up to 4 years after DES implantation
procedures, with varying clinical presentations. Mr. X, 60 years old diabetic, hypertensive got admitted in
NICVD and was diagnosed as a case of Chronic Stable Angina. His ETT was strongly positive, CAG
showed significant long lesion in LAD. Direct stenting with DES to LAD done and whole procedure was
uneventful. After 10 days of PCI patient got readmitted in hospital with complaints of chest discomfort
with high grade fever for 2 days. ECG showed AMI (Extensive Anterior) indicating involvement of LAD
territory with strong suspicion of Sub Acute Stent Thrombosis (SAST). Streptokinase could not be given
due to delayed arrival. Patient was treated conservatively with Low Molecular Weight Heparin. Check
CAG was done 7 days after readmission showing Patent stent in LAD with aneurysmal dilatation at the
distal end of stent in LAD. The objective of this case report is to focus on the rare but not uncommon
incidence of stent implantation.
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Keywords
Coronary artery aneurysm, DES
Citation
Choudhury A K, Akhtaruzzaman M, Khalequzzaman M, Hasem S, Choudhury T A, Sharafat N I. Drug-Eluting Stent (DES) Induced Coronary Artery Aneurysm - A Case Report. Cardiovascular Journal. 2013; 6(1): 63-67.