Korean Circ J.  2007 Mar;37(3):127-129. 10.4070/kcj.2007.37.3.127.

A Case of Coronary Artery Aneurysm after Sirolimus-Eluting Stent Implantation

• Park KS
• Cha ST
• Sung JH
• Kim IJ
• Lim SW
• Cha DH

• KMID: 2227084
• DOI: http://doi.org/10.4070/kcj.2007.37.3.127

Abstract

This report describes the case of a 26-year-old male diagnosed with angina on exertion. A diagnostic coronary angiography revealed significant luminal narrowing at the middle third of the left anterior descending artery and proximal circumflex artery. The patient underwent implantation of sirolimus-eluting stents. Eight months after implantation of the stents, a follow-up coronary angiography showed intrastent coronary artery aneurysms. We suggest that the implantation of the sirolimus-eluting stent caused late formation of a coronary artery aneurysm.

Keyword

Coronary aneurysm; Sirolimus; Stent

MeSH Terms

Adult
Aneurysm*
Arteries
Coronary Aneurysm
Coronary Angiography
Coronary Vessels*
Follow-Up Studies
Humans
Male
Phenobarbital
Sirolimus
Stents*
Phenobarbital
Sirolimus

Figure

• 

  Fig. 1 A diagnostic coronary angiography revealed significant stenosis at the middle third of the left anterior descending artery and proximal circumflex artery.

• 

  Fig. 2 A coronary angiography after the implantation of sirolimus-eluting stents showed minimal residual stenosis.

• 

  Fig. 3 months after implantation of the sirolimus-eluting stents, a coronary angiography disclosed the presence of coronary artery aneurysms at the

Reference

1. Slota PA, Fischman DL, Savage M, Rake R, Goldberg S. Frequency and outcome of development of coronary artery aneurysm after intracoronary stent placement and angioplasty. Am J Cardiol. 1997. 79:1104–1106.

2. Bal ET, Thijs Plokker HW, van de Berg EM, et al. Predictability and prognosis of PTCA-induced coronary artery aneurysms. Cathet Cardiovasc Diagn. 1991. 22:85–88.

3. Degertekin M, Serruys PW, Tanabe K, et al. Long-term follow-up of incomplete stent apposition in patients who received sirolimus-eluting stent for de novo coronary lesions: an intravascular ultrasound analysis. Circulation. 2003. 108:2747–2750.

4. Virmani R, Guagliumi G, Farb A, et al. Localized hypersensitivity and coronary thrombosis secondary to a sirolimus-eluting stent: should we be more cautious? Circulation. 2004. 109:701–705.

5. Vik-Mo H, Wiseth R, Hegbom K. Coronary aneurysm after implantation of a paclitaxel-eluting stent. Scand Cardiovasc J. 2004. 38:349–352.

6. Morice MC, Serruys PW, Souza JE, et al. A randomized comparison of a sirolimus-eluting stent with a standard stent for coronary revascularization. N Engl J Med. 2002. 346:1773–1780.

7. Moses JW, Leon M, Popma JJ, et al. Sirolimus-eluting stents versus standard stents in patients with stenosis in a native coronary artery. N Engl J Med. 2003. 349:1315–1323.

8. Roque M, Cordon-Cardo C, Fuster V, Reis ED, Drobnjak M, Badimon JJ. Modulation of apoptosis, proliferation and p27 expression in a porcine coronary angioplasty model. Atherosclerosis. 2000. 153:315–322.

9. Nilsen DW, Melberg T, Larsen AI, Barvik S, Bonarjee V. Late complications following the deployment of drug eluting stents. Int J Cardiol. 2006. 109:398–401.

10. Li SS, Cheng BC, Lee S. Giant coronary aneurysm formation after sirolimus-eluting stent implantation in Kawasaki disease. Circulation. 2005. 112:e105–e107.

11. Yun HJ, Kim KS, Hur SH, Park NH, Cho YW. A case report of a huge coronary artery aneurysm with acute myocardial infarction. Korean Circ J. 2002. 32:720–724.

12. Briguroi C, Sarais C, Sivieri G, Takagi T, di Mario C, Colombo A. Polytetrafluoroethylene-covered stent and coronary artery aneurysms. Catheter Cardiovasc Interv. 2002. 55:326–330.

13. Kim HG, Jeong MH, Kim W, et al. Successful stent grafting for a coronary aneurysm. Korean Circ J. 2004. 34:507–511.

14. Yamaguchi H, Yamauchi H, Yamada T, Ariyoshi T. Surgical repair of coronary artery aneurysm after percutaneous coronary intervention. Jpn Circ J. 2001. 65:52–55.