In-stent restenosis and longitudinal stent deformation: a case report
Abstract Background Longitudinal stent deformation (LSD) is an infrequent complication of percutaneous coronary intervention (PCI), and it may lead to catastrophic clinical outcomes. However, reports of cardiac adverse events associated with LSD are rare. Case presentation A 55-year-old man with che...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-01-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | https://doi.org/10.1186/s12872-020-01335-1 |
| _version_ | 1818665277010739200 |
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| author | Daoyuan Si Yaliang Tong Bo Yu Yuquan He Guohui Liu |
| author_facet | Daoyuan Si Yaliang Tong Bo Yu Yuquan He Guohui Liu |
| author_sort | Daoyuan Si |
| collection | DOAJ |
| description | Abstract Background Longitudinal stent deformation (LSD) is an infrequent complication of percutaneous coronary intervention (PCI), and it may lead to catastrophic clinical outcomes. However, reports of cardiac adverse events associated with LSD are rare. Case presentation A 55-year-old man with chest pain was treated for a severe left anterior descending branch (LAD)-diagonal 1 (D1) bifurcation lesion by PCI with two stents in the proximal LAD. LSD occurred during the withdrawal of the trapped D1 wire. High-pressure balloon dilatation was performed in the deformed stent, and the end-angiographic appearance was acceptable, but no additional corrective measures were implemented. Ten months later, the patient represented with acute coronary syndrome. Severe in-stent restenosis (ISR) had suboccluded the proximal LAD, and optical coherence tomography (OCT) visualized multilayered stent struts protruding into the lumen at the compressed segment of the stent. Following complete apposition with balloon dilation, a drug-coated balloon (DCB) was used to avoid an additional permanent metallic layer. He remained angina free, and the angiographic result demonstrated no residual stenosis at the six-month follow-up. To our knowledge, this case demonstrates the first report of ISR triggered by LSD in patients treated with DCBs under the guidance of OCT. Conclusions The current report underscores the importance of awareness of LSD, and OCT seems to be the preferred modality to confirm complete apposition. If left without performing additional corrective measures, LSD may be associated with a risk of ISR. Complete apposition with balloon dilation followed by a DCB is a feasible treatment option. |
| first_indexed | 2024-12-17T05:46:04Z |
| format | Article |
| id | doaj.art-f2903969686a485982ca0a03382dcee3 |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-12-17T05:46:04Z |
| publishDate | 2020-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-f2903969686a485982ca0a03382dcee32022-12-21T22:01:18ZengBMCBMC Cardiovascular Disorders1471-22612020-01-012011410.1186/s12872-020-01335-1In-stent restenosis and longitudinal stent deformation: a case reportDaoyuan Si0Yaliang Tong1Bo Yu2Yuquan He3Guohui Liu4Department of Cardiology, China-Japan Union Hospital of Jilin UniversityDepartment of Cardiology, China-Japan Union Hospital of Jilin UniversityDepartment of Cardiology, China-Japan Union Hospital of Jilin UniversityDepartment of Cardiology, China-Japan Union Hospital of Jilin UniversityDepartment of Cardiology, China-Japan Union Hospital of Jilin UniversityAbstract Background Longitudinal stent deformation (LSD) is an infrequent complication of percutaneous coronary intervention (PCI), and it may lead to catastrophic clinical outcomes. However, reports of cardiac adverse events associated with LSD are rare. Case presentation A 55-year-old man with chest pain was treated for a severe left anterior descending branch (LAD)-diagonal 1 (D1) bifurcation lesion by PCI with two stents in the proximal LAD. LSD occurred during the withdrawal of the trapped D1 wire. High-pressure balloon dilatation was performed in the deformed stent, and the end-angiographic appearance was acceptable, but no additional corrective measures were implemented. Ten months later, the patient represented with acute coronary syndrome. Severe in-stent restenosis (ISR) had suboccluded the proximal LAD, and optical coherence tomography (OCT) visualized multilayered stent struts protruding into the lumen at the compressed segment of the stent. Following complete apposition with balloon dilation, a drug-coated balloon (DCB) was used to avoid an additional permanent metallic layer. He remained angina free, and the angiographic result demonstrated no residual stenosis at the six-month follow-up. To our knowledge, this case demonstrates the first report of ISR triggered by LSD in patients treated with DCBs under the guidance of OCT. Conclusions The current report underscores the importance of awareness of LSD, and OCT seems to be the preferred modality to confirm complete apposition. If left without performing additional corrective measures, LSD may be associated with a risk of ISR. Complete apposition with balloon dilation followed by a DCB is a feasible treatment option.https://doi.org/10.1186/s12872-020-01335-1In-stent restenosisLongitudinal stent deformationOptical coherence tomographyComplication |
| spellingShingle | Daoyuan Si Yaliang Tong Bo Yu Yuquan He Guohui Liu In-stent restenosis and longitudinal stent deformation: a case report BMC Cardiovascular Disorders In-stent restenosis Longitudinal stent deformation Optical coherence tomography Complication |
| title | In-stent restenosis and longitudinal stent deformation: a case report |
| title_full | In-stent restenosis and longitudinal stent deformation: a case report |
| title_fullStr | In-stent restenosis and longitudinal stent deformation: a case report |
| title_full_unstemmed | In-stent restenosis and longitudinal stent deformation: a case report |
| title_short | In-stent restenosis and longitudinal stent deformation: a case report |
| title_sort | in stent restenosis and longitudinal stent deformation a case report |
| topic | In-stent restenosis Longitudinal stent deformation Optical coherence tomography Complication |
| url | https://doi.org/10.1186/s12872-020-01335-1 |
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