A case of a coronary covered stent for repeated restenosis at the anastomosis site between saphenous vein graft and graft prosthesis

  • Masaomi Gohbara
    Correspondence
    Corresponding author at: Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
    Affiliations
    Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
    Search for articles by this author
  • Teruyasu Sugano
    Affiliations
    Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
    Search for articles by this author
  • Toshiyuki Ishikawa
    Affiliations
    Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
    Search for articles by this author
  • Kouichi Tamura
    Affiliations
    Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
    Search for articles by this author
  • Kazuo Kimura
    Affiliations
    Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan

    Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
    Search for articles by this author

      Abstract

      A 56-year-old man was admitted with a diagnosis of non-ST-segment elevation myocardial infarction, after surgery for total arch replacement, aortic root replacement with a mechanical aortic valve, and coronary artery reconstruction by the Piehler method for acute aortic dissection. Coronary angiography (CAG) revealed a 99% stenosis of the anastomosis site between the J Graft (Japan Lifeline, Tokyo, Japan) and the saphenous vein graft (SVG), which was distally sutured to his right coronary artery (posterior descending artery). After percutaneous coronary intervention (PCI) with a drug-eluting stent to the anastomosis site, repeated in-stent restenosis unfortunately occurred. Despite repeated PCIs, he was again admitted due to exertional angina pectoris, with proven inferior myocardial ischemia by stress myocardial perfusion imaging. We therefore decided to use a coronary covered stent for the anastomosis site to seal neointimal proliferation. GRAFTMASTER 2.8/19 mm (Abbott, CA, USA) was implanted in the anastomosis site, and a follow-up CAG one-year later revealed that the covered stent was clearly opened. To the best of our knowledge, this is the first paper to demonstrate the usefulness of a covered stent for repeated restenosis of the anastomosis site between SVG and graft prostheses.

      Keywords

      To read this article in full you will need to make a payment

      References

        • Saito Y
        • Kobayashi Y
        • Tanabe K
        • Ikari Y.
        Antithrombotic therapy after percutaneous coronary intervention from the Japanese perspective.
        Cardiovasc Interv Ther. 2020; 35: 19-29
        • Schächinger V
        • Hamm CW
        • Münzel T
        • Haude M
        • Baldus S
        • Grube E
        • Bonzel T
        • Konorza T
        • Köster R
        • Arnold R
        • Haase J
        • Probst P
        • vom Dahl J
        • Neumann FJ
        • Mudra H
        • et al.
        A randomized trial of polytetrafluoroethylene-membrane-covered stents compared with conventional stents in aortocoronary saphenous vein grafts.
        J Am Coll Cardiol. 2003; 42: 1360-1369
        • Stankovic G
        • Colombo A
        • Presbitero P
        • van den Branden F
        • Inglese L
        • Cernigliaro C
        • Niccoli L
        • Bartorelli AL
        • Rubartelli P
        • Reifart N
        • Heyndrickx GR
        • Saunamäki K
        • Morice MC
        • Sgura FA
        • Di Mario C.
        Randomized evaluation of polytetrafluoroethylene-covered stent in saphenous vein grafts: the Randomized Evaluation of polytetrafluoroethylene COVERed stent in Saphenous vein grafts (RECOVERS) Trial.
        Circulation. 2003; 108: 37-42
        • Aoki J
        • Tanabe K.
        Mechanisms of drug-eluting stent restenosis.
        Cardiovasc Interv Ther. 2021; 36: 23-29
        • Slezak P
        • Klang A
        • Ferguson J
        • Monforte X
        • Schmidt P
        • Bauder B
        • Url A
        • Osuchowski M
        • Redl H
        • Spazierer D
        • Gulle H.
        Tissue reactions to polyethylene glycol and glutaraldehyde-based surgical sealants in a rabbit aorta model.
        J Biomater Appl. 2020; 34: 1330-1340
        • Luk A
        • David TE
        • Butany J.
        Complications of Bioglue postsurgery for aortic dissections and aortic valve replacement.
        J Clin Pathol. 2012; 65: 1008-1012
        • Kimura T
        • Itoh T
        • Sugawara S
        • Fusazaki T
        • Nakamura M
        • Morino Y.
        Serial endovascular assessment of polytetrafluoroethylene-covered stent: Capabilities and limitations of intravascular imaging modalities affected by a temporal factor.
        J Cardiol Cases. 2015; 11: 91-95
        • Takano M
        • Yamamoto M
        • Inami S
        • Xie Y
        • Murakami D
        • Okamatsu K
        • Ohba T
        • Seino Y
        • Mizuno K.
        Delayed endothelialization after polytetrafluoroethylene-covered stent implantation for coronary aneurysm.
        Circ J. 2009; 73: 190-193
        • Kongoji K
        • Ishibashi Y
        • Kotoku N
        • Kasahara M
        • Yamazaki H
        • Mitarai T
        • Kamijima R
        • Koyama K
        • Yoneyama K
        • Tanabe Y
        • Akashi YJ.
        Angioscopic and optical coherence tomographic evaluation of neointimal coverage: 9 months after expandable polyterafluoroethylene covered stent implantation.
        Heart Vessels. 2017; 32: 777-779