Stent Inflammation: Stent Footprint in Restenotic Tissue Retrieved by Directional Atherectomy

M. Meuwissen
2002 Circulation  
A 68-year-old woman was treated for diffuse in-stent restenosis 5 months after implantation of a 13-mm Multilink stent (Guidant) in the proximal segment of the right coronary artery ( Figure 1A ). Debulking of the in-stent restenotic lesion was performed using directional coronary atherectomy (DCA) followed by adjunctive balloon angioplasty ( Figure 1B ). Six months after atherectomy, the patient was asymptomatic and routine coronary angiography demonstrated a good long-term result ( Figure 1C
more » ... result ( Figure 1C ). Macroscopic examination of the retrieved DCA specimen revealed a partially removed stent strut (arrow, Figure 2A ) within transparent blueish homogeneous tissue. The atherectomy specimen was analyzed histologically and contained mainly smooth muscle cells. At regular intervals along the edge, distinct clusters of T lymphocytes and macrophages (not shown) occurred, suggesting inflammatory cell clustering at the site of stent struts (Figures 2B and 2C ). These immunohistochemical images illustrate a stent-strutinduced inflammation of an in-stent restenotic lesion retrieved by DCA.
doi:10.1161/01.cir.0000029209.89156.88 pmid:12196348 fatcat:2z4kvjgfdne5fpnmnuzbszi5i4