A case of active peri-stent inflammation after sirolimus-eluting stent implantation

• Published in: Heart and vessels Vol. 30; no. 2; pp. 270 - 273
• Main Authors: Kurosawa, Takafumi, Kotani, Jun-ichi, Matsuyama, Taka-aki, Ishibashi-Ueda, Hatsue
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.03.2015; Springer Nature B.V
• Subjects: Aged, 80 and over; Aneurysms; Angioplasty; Autopsy; Biomedical Engineering and Bioengineering; Cardiac Surgery; Cardiology; Cardiovascular Agents - administration & dosage; Case Report; Coronary Aneurysm - diagnosis; Coronary Aneurysm - etiology; Coronary Angiography; Coronary Artery Disease - diagnosis; Coronary Artery Disease - therapy; Coronary Vessels - diagnostic imaging; Coronary Vessels - injuries; Coronary Vessels - pathology; Drug-Eluting Stents; Drugs; Everolimus - administration & dosage; Fatal Outcome; Female; Heart Injuries - diagnosis; Heart Injuries - etiology; Humans; Inflammation - diagnosis; Inflammation - etiology; Inflammatory diseases; Medicine; Medicine & Public Health; Pathology; Percutaneous Coronary Intervention - adverse effects; Percutaneous Coronary Intervention - instrumentation; Prosthesis Design; Stents; Treatment Outcome; Ultrasonography, Interventional; Vascular Surgery; Vascular System Injuries - diagnosis; Vascular System Injuries - etiology; Pathology; Inflammation; Percutaneous coronary intervention; Drug-eluting stent
• ISSN: 0910-8327; 1615-2573
• DOI: 10.1007/s00380-013-0465-4

We report an autopsy case of a coronary aneurysm with massive adventitial inflammation post-percutaneous coronary intervention with sirolimus-eluting stent (SES) insertion in the left circumflex (LCX) coronary artery for ischemic heart disease 3 years prior to death. The internal elastic membrane was disrupted opposite the site of the eccentric LCX plaque due to injury during stenting, and the adventitia showed massive inflammatory cell infiltration, mainly consisting of eosinophils. The LCX showed aneurysmal dilatation with inflammatory cell infiltration. Inappropriate SES implantation attracted chronic inflammation. Chronic inflammation can lead to the development of coronary artery aneurysms.