Objective: To analyze the reason of coronary artery aneurysmal dilations in patients after sirolimus-eluting stent implantation.
Methods: Late localized aneurysmal dilations post PCI were evidenced in 4 patients (age 69.5 +/- 3.5 years, 3 males) during follow-up (24.8 +/- 1.8 months). Nine stents were implanted into 7 diseased vessels: 5 Cypher select stents in LAD; 2 Firebird stents and 1 Pixel stent in LCX; 1 Cypher select stent in RCA. Clopidogrel (75 mg/d) was used for one year.
Results: All stents were implanted successfully after predilation. No acute or subacute in-stent thrombosis and MACE was recorded. Follow-up angiogram imaging at 12 months after stenting was normal in all patients. Chest pain reoccurred in these 4 patients at 16, 18, and 22 months post stent implantation and patients were rehospitalized and treated with clopidogrel, asprine, and intravenous nitroglycerin. Angiography showed aneurysmal segment at the stented site of LAD in 3 patients, and at RCA in 1 patient. The symptom disappeared after 3 days intravenous tirofiban treatments and discharged without in-hospital complications. Patients remained symptom-free 3 - 6 months post discharge.
Conclusion: Late localized aneurysmal dilations after sirolimus-eluting stents are related to reoccurred angina pectoris post PCI.