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A patient with repeated catastrophic multi-vessel coronary spasm after zotarolimus-eluting stent implantation.

Rhew SH, Ahn Y, Cho EA, Kim MS, Jang SY, Lee KH, Lee MG, Park KH, Sim DS, Hong YJ, Kim JH, Jeong MH - Korean Circ J (2013)

Bottom Line: Drug-eluting stents (DES) have gained great popularity because of extraordinarily low rates of restenosis.Despite these superior clinical outcomes, several cases regarding the severe multi-vessel coronary spasm, although rare, after the placement of first generation DES have been reported.The first incidence was relieved by intracoronary nitroglycerin alone, and second incident, which had combined fixed stenosis was treated with intracoronary nitroglycerin and everolimus-eluting stent.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Cardiovascular Center, Chonnam National University Hospital, Gwangju, Korea.

ABSTRACT
Drug-eluting stents (DES) have gained great popularity because of extraordinarily low rates of restenosis. Despite these superior clinical outcomes, several cases regarding the severe multi-vessel coronary spasm, although rare, after the placement of first generation DES have been reported. We report a case of severe, multi-vessel coronary spasm that occurred two occasions after placement of a zotarolimus-eluting stent, one of the second generation DES, in a 42-year-old man with unstable angina. The first incidence was relieved by intracoronary nitroglycerin alone, and second incident, which had combined fixed stenosis was treated with intracoronary nitroglycerin and everolimus-eluting stent.

No MeSH data available.


Related in: MedlinePlus

Coronary angiogram at first admission. A: significant stenosis (arrow) in mid left anterior descending artery (LAD) (right anterior oblique cranial view). B: no significant stenosis in right coronary artery (left anterior oblique caudal view). C: good distal flow after drug-eluting stent implantation (2.75×18 mm Endeavor-R stent) in the mid LAD artery (right anterior oblique cranial view).
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Figure 1: Coronary angiogram at first admission. A: significant stenosis (arrow) in mid left anterior descending artery (LAD) (right anterior oblique cranial view). B: no significant stenosis in right coronary artery (left anterior oblique caudal view). C: good distal flow after drug-eluting stent implantation (2.75×18 mm Endeavor-R stent) in the mid LAD artery (right anterior oblique cranial view).

Mentions: A 42-year-old man was admitted to Chonnam National University Hospital (Gwangju, Korea) for acute chest pain. He was an ex-smoker with a 20 pack-years history, but he didn't have any other significant past-medical history such as dyslipidemia, diabetes or hypertension. He had been on regular anti-anginal medication over the past two years since he underwent pecutaneous coronary intervention (PCI) with a 2.75×18 mm zotarolimus-eluting stent (Endeavor Resolute®, Medtronic vascular, Santa Rosa, CA, USA) in the mid-left anterior descending artery (LAD) due to unstable angina pectoris (Fig. 1).


A patient with repeated catastrophic multi-vessel coronary spasm after zotarolimus-eluting stent implantation.

Rhew SH, Ahn Y, Cho EA, Kim MS, Jang SY, Lee KH, Lee MG, Park KH, Sim DS, Hong YJ, Kim JH, Jeong MH - Korean Circ J (2013)

Coronary angiogram at first admission. A: significant stenosis (arrow) in mid left anterior descending artery (LAD) (right anterior oblique cranial view). B: no significant stenosis in right coronary artery (left anterior oblique caudal view). C: good distal flow after drug-eluting stent implantation (2.75×18 mm Endeavor-R stent) in the mid LAD artery (right anterior oblique cranial view).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3569567&req=5

Figure 1: Coronary angiogram at first admission. A: significant stenosis (arrow) in mid left anterior descending artery (LAD) (right anterior oblique cranial view). B: no significant stenosis in right coronary artery (left anterior oblique caudal view). C: good distal flow after drug-eluting stent implantation (2.75×18 mm Endeavor-R stent) in the mid LAD artery (right anterior oblique cranial view).
Mentions: A 42-year-old man was admitted to Chonnam National University Hospital (Gwangju, Korea) for acute chest pain. He was an ex-smoker with a 20 pack-years history, but he didn't have any other significant past-medical history such as dyslipidemia, diabetes or hypertension. He had been on regular anti-anginal medication over the past two years since he underwent pecutaneous coronary intervention (PCI) with a 2.75×18 mm zotarolimus-eluting stent (Endeavor Resolute®, Medtronic vascular, Santa Rosa, CA, USA) in the mid-left anterior descending artery (LAD) due to unstable angina pectoris (Fig. 1).

Bottom Line: Drug-eluting stents (DES) have gained great popularity because of extraordinarily low rates of restenosis.Despite these superior clinical outcomes, several cases regarding the severe multi-vessel coronary spasm, although rare, after the placement of first generation DES have been reported.The first incidence was relieved by intracoronary nitroglycerin alone, and second incident, which had combined fixed stenosis was treated with intracoronary nitroglycerin and everolimus-eluting stent.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Cardiovascular Center, Chonnam National University Hospital, Gwangju, Korea.

ABSTRACT
Drug-eluting stents (DES) have gained great popularity because of extraordinarily low rates of restenosis. Despite these superior clinical outcomes, several cases regarding the severe multi-vessel coronary spasm, although rare, after the placement of first generation DES have been reported. We report a case of severe, multi-vessel coronary spasm that occurred two occasions after placement of a zotarolimus-eluting stent, one of the second generation DES, in a 42-year-old man with unstable angina. The first incidence was relieved by intracoronary nitroglycerin alone, and second incident, which had combined fixed stenosis was treated with intracoronary nitroglycerin and everolimus-eluting stent.

No MeSH data available.


Related in: MedlinePlus