Development of Coronary Aneurysm after Drug-Eluting Stent Implantation

Letters6 February 2007Development of Coronary Aneurysm after Drug-Eluting Stent ImplantationAnthony A. Bavry, MD, MPH, John H. Chiu, MD, Brian K. Jefferson, MD, Juhana Karha, MD, Deepak L. Bhatt, MD, Stephen G. Ellis, MD, and Patrick L. Whitlow, MDAnthony A. Bavry, MD, MPHFrom Cleveland Clinic Foundation, Cleveland, Ohio.Search for more papers by this author, John H. Chiu, MDFrom Cleveland Clinic Foundation, Cleveland, Ohio.Search for more papers by this author, Brian K. Jefferson, MDFrom Cleveland Clinic Foundation, Cleveland, Ohio.Search for more papers by this author, Juhana Karha, MDFrom Cleveland Clinic Foundation, Cleveland, Ohio.Search for more papers by this author, Deepak L. Bhatt, MDFrom Cleveland Clinic Foundation, Cleveland, Ohio.Search for more papers by this author, Stephen G. Ellis, MDFrom Cleveland Clinic Foundation, Cleveland, Ohio.Search for more papers by this author, and Patrick L. Whitlow, MDFrom Cleveland Clinic Foundation, Cleveland, Ohio.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-146-3-200702060-00146 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: The problem of drug-eluting stents increasing the risk for late thrombosis, especially when antiplatelet therapy becomes interupted, is a growing concern (1). Recently, a new association with these devices was observed at our institution (Cleveland Clinic, Cleveland, Ohio).Objective: To report cases of coronary aneurysm after drug-eluting stent implantation and to describe the different strategies used to treat the problem.Case Report: An aneurysm (8 mm in diameter by intravascular ultrasonography) was discovered in a 49-year-old woman 19 months after implantation of a sirolimus-eluting stent (CYPHER, Cordis Corp., Miami Lakes, Florida) (Figure 1). The patient underwent excision of the ...References1. Bavry AA, Kumbhani DJ, Helton TJ, Borek PP, Mood GR, Bhatt DL. Late thrombosis of drug eluting stents: a meta-analysis of randomized clinical trials. Am J Med. 2006;119:1056-61. [In press]. Google Scholar2. Stone GW, Ellis SG, Cannon L, Mann JT, Greenberg JD, Spriggs D. Comparison of a polymer-based paclitaxel-eluting stent with a bare metal stent in patients with complex coronary artery disease: a randomized, controlled trial. JAMA. 2005;294:1215-23. [PMID: 16160130] CrossrefMedlineGoogle Scholar3. Joner M, Finn AV, Farb A, Mont EK, Kolodgie FD, Ladich E, et al. Pathology of drug-eluting stents in humans: delayed healing and late thrombotic risk. J Am Coll Cardiol. 2006;48:193-202. [PMID: 16814667] CrossrefMedlineGoogle Scholar4. Farb A, Burke AP, Kolodgie FD, Virmani R. Pathological mechanisms of fatal late coronary stent thrombosis in humans. Circulation. 2003;108:1701-6. [PMID: 14504181] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Cleveland Clinic Foundation, Cleveland, Ohio.Disclosures: Consultancies: D.L. Bhatt (AstraZeneca, Bristol-Myers Squibb, Centocor, Daiichi Sankyo, Eisai, Eli Lilly Inc., GlaxoSmithKline, Millenium, Otsuka, ParinGenix, PDL BioPharma, Sanofi-Aventis, Schering-Plough, The Medicines Company), S.G. Ellis (Boston Scientific, Celera Diagnostics, Cordis, Viacor); Honoraria: A.A. Bavry (Genesis), D.L. Bhatt (AstraZeneca, Bristol-Myers Squibb, Centocor, Daiichi Sankyo, Eisai, Eli Lilly Inc., GlaxoSmithKline, Millenium, Otsuka, ParinGenix, PDL BioPharma, Sanofi-Aventis, Schering-Plough, The Medicines Company); Grants received: D.L. Bhatt (Bristol-Myers Squibb, Sanofi-Aventis, Eisai, The Medicines Company); P.L. Whitlow (Abbott, Boston Scientific, Cordis, Edwards Lifesciences, Evalve Inc., ev3 Inc.). Dr. Whitlow is an advisor and member of the board of directors for ICON Interventional Systems and Medilogics, and Dr. Bhatt has served on speakers' bureaus for Bristol-Myers Squibb, Sanofi-Aventis, and The Medicines Company. 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A reviewBalancing Efficacy and Safety of Drug-Eluting Stents in Patients Undergoing Percutaneous Coronary InterventionAllen Jeremias, MD, MSc and Ajay Kirtane, MD, SMCoronary Artery Aneurysms After Drug-Eluting Stent ImplantationEndoprothèses coronaires et angioplastie transluminale des artères coronairesThe haemocompatibility of polyurethane–hyaluronic acid copolymersA serial ultrasound assessment of neoaneurysm following paclitaxel-eluting stent implantation 6 February 2007Volume 146, Issue 3Page: 230-232KeywordsAneurysmsArteriesDiagnostic techniquesDrug therapyDrugsHypersensitivityPathogenesisStent implantationThrombosisUltrasound imaging ePublished: 6 February 2007 Issue Published: 6 February 2007 CopyrightCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...