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KMID : 0368120080380030174
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Korean Circulation Journal
2008 Volume.38 No. 3 p.174 ~ p.178
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A Case of Late Recurrent Vasospasm After Sirolimus-Eluting Stent Implantation
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Lee Tae-Keun
Lee Han-Cheol
Hwang Ki-Won
Chun Kook-Jin
Hong Taek-Jong
Shin Yung-Woo
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Abstract
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A 67-year-old male with stable angina was admitted to our cardiovascular center. He had neither any history of smoking, diabetes mellitus, hypertension, cerebrovascular accident nor family history of coronary artery disease. Coronary angiography showed a 90% tubular eccentric luminal narrowing at the mid left anterior descending artery (m-LAD). A sirolimus-eluting stent (SES) was implanted in the m-LAD. Coronary angiography performed after 9 months did not reveal restenosis or recurrent coronary artery disease. However, the patient returned to the emergency room with severe chest pain after 17 months. Coronary angiography showed severe diffuse vasospasm distal to the m-LAD stent site. After 20 days, vasospastic myocardial infarction developed. A zotarolimus-eluting stent with a phosphorylcholine polymer was implanted distal to the m-LAD stent. The zotarolimus-eluting stent was used because the polymer in the SES or sirolimus was considered a possible cause for the recurrent vasospasm. The patient had no further chest pain during the 9 months after zotarolimus-eluting stent implantation. We suspect that the polymer in the SES or sirolimus might have caused endothelial dysfunction and provoked the late vasospasm. Here, we describe this case of late recurrent vasospasm after SES implantation
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KEYWORD
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Coronary vasospasm, Endothelium, vascular, Drug-eluting stent
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