An expandable polytetrafluoroethylene (PTFE)-covered stent graft is beneficial for
the treatment of coronary perforations. However, several reports have shown that restenosis
and thrombotic occlusion occasionally occur in the stented segment after PTFE-covered
stent implantation. A restenosis case after treatment with PTFE-covered stent against
saphenous vein graft (SVG) perforation has never been evaluated with optical coherence
tomography (OCT) or coronary angioscopy (CAS). This case report presents a 75-year-old
man treated with a PTFE-covered stent after he suffered from SVG perforation 6 months
ago. He was found to have a focal restenosis of the distal edge of the PTFE-covered
stent and underwent percutaneous coronary intervention. OCT showed focal restenosis
with homogeneous neointima and exposed struts in the middle and proximal part of the
PTFE-covered stent. CAS showed white neointima with a smooth surface at the restenosis
site and a sharp border against proximal exposed struts with characteristic links.
This case study showed, for the first time in vivo and in a human, the neointimal
characteristics of restenosis and uncovered stent struts in a PTFE-covered stent which
had been implanted 6 months before. The delayed endothelialization was sustained until
12 months after implantation.
Keywords
percutaneous coronary intervention - polytetrafluoroethylene-covered stent - case
study - coronary angioscopy - optical coherence tomography - PCI - OCT
