Abstract
We encountered a case of late regression after sirolimus-eluting stent restenosis. We report this case with intravascular ultrasound imaging demonstrating an intraluminal echolucent tissue, which looks like a black hole.
Although there are reports about late catch-up intimal hyperplasia growth after drug-eluting stent (DES) implantation , little information regarding late regression after DES implantation is available, while several studies have reported late regression after bare metal stent implantation .
In January 2005, a 72-year-old man underwent stent implantation (Cypher; Cordis Corp., Miami, FL, USA) for a de novo lesion in the left anterior descending coronary artery. Angiography scheduled at 6 months revealed mild restenosis in the middle segment of the stent ( Fig. 1 left), yet the patient had no chest pain or ischemia by stress scintigraphy. At 3 years after stent implantation, chest pain recurred . Angiography revealed improvement in luminal diameter (late regression) at the middle segment and progression (late catch-up) at the proximal segment within the stent ( Fig. 1 right). Intravascular ultrasound examination at 3 years ( Fig. 2 ) demonstrated an intraluminal echolucent tissue, which looks like a black hole , at the regression site and typical neointimal hyperplasia (homogeneous, echoreflective appearance) at the late catch-up site.
