Document Detail


Optical coherence tomography assessment of a coronary bare cobalt chromium stent deformed by the removal of an entrapped "jailed" guidewire.
MedLine Citation:
PMID:  20814056     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 64-year-old male with an ongoing acute coronary syndrome was treated percutaneously for a subtotal occlusion of a first diagonal branch. After predilatation of the diagonal, an important secondary branch was evident at the level of the subocclusion. A jailed wire was placed in this vessel, and stenting of the main diagonal branch was performed with a last-generation thin-strut bare cobalt-chromium stent. Conventional retrieval of the jailed wire was impossible, as the distal tip of the wire remained entrapped at the level of the stent. The strong pulling of the wire led only to a deep intubation of the guiding catheter with possible risk of dissection. Retrieval of the wire was finally possible with the support of an over-the-wire microcatheter. However, the stent, though still patent, appeared deformed. At a scheduled control angiogram 4 months later (while the patient was still asymptomatic), an optical coherence tomography (OCT) investigation of the stented segment confirmed the deformation of the stent. OCT showed a complete lack of stent struts on the side of origin of the secondary branch and an "overlap" or "accumulation" of several layers of stent struts on the other side. There were no signs of uncovered struts overall nor malapposition, and even the sites where multiple stent layers were visible were completely covered by neointimal hyperplasia. Despite the multiple layers of metal, the neointimal reaction was moderate and did not lead to a flow-limiting stenosis, thus the patient was further treated medically without the need for a new intervention.
Authors:
Pierfrancesco Agostoni; Eric Van Belle; Pieter R Stella
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  22     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-03     Completed Date:  2011-01-19     Revised Date:  2011-02-09    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  453-5     Citation Subset:  IM    
Affiliation:
University Medical Center Utrecht, Department of Cardiology, Heidelberglaan 100, Utrecht, 3584 CX, Netherlands. agostonipf@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / pathology,  radiography,  therapy*
Angioplasty, Balloon, Coronary / adverse effects*,  instrumentation
Chromium Alloys
Coronary Angiography
Device Removal / adverse effects*
Humans
Male
Middle Aged
Stents / adverse effects*
Tomography, Optical Coherence*
Chemical
Reg. No./Substance:
0/Chromium Alloys

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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