Incidence and natural history of coronary artery aneurysm developing after drug-eluting stent implantation

Chul Min Ahn, Bum Kee Hong, Jong Youn Kim, Pil Ki Min, Young W. Yoon, Byoung K. Lee, Hyuck M. Kwon, Jung Sun Kim, Young Guk Ko, Donghoon Choi, Myeong Ki Hong, Yangsoo Jang, Won Heum Shim, Seung Yun Cho, Byeong Keuk Kim, Seongjin Oh, Dong W. Jeon, Joo Y. Yang, Jae Hun Jung

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Abstract

Aims: There is a growing concern about the occurrence of coronary artery aneurysms (CAAs) after drug-eluting stent (DES) implantation and their long-term course. We assessed the occurrence and the factors affecting the long-term outcome of DES-associated CAA. Methods and Results: We analyzed 3,612 consecutive patients (4,419 lesions) who underwent follow-up angiography after DES implantation. All 34 CAAs (0.76% per lesion) in 29 patients (0.8% per patient) were detected at follow-up, and the mean elapsed time from DES implantation to CAA diagnosis was 414 ± 213 days. Angiographically, CAAs developed almost exclusively in complex (type B2/C) de novo lesions (30 [88.2%] of 34 lesions), and lesion length was significantly greater in patients with CAA than without CAA (26.9 ± 9.03 vs 23.1 ± 7.14 mm; P = .004). Myocardial infarction with stent thrombosis occurred in 5 patients with CAA (17.2%), 4 of whom were on aspirin only without clopidogrel. Conclusion: Although CAAs rarely develop after DES implantation and show mostly favorable clinical courses, long-term maintenance of clopidogrel therapy might be required to minimize occurrence of adverse clinical events resulting from stent thrombosis.

Original languageEnglish
Pages (from-to)987-994
Number of pages8
JournalAmerican heart journal
Volume160
Issue number5
DOIs
Publication statusPublished - 2010 Nov 1

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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    Ahn, C. M., Hong, B. K., Kim, J. Y., Min, P. K., Yoon, Y. W., Lee, B. K., Kwon, H. M., Kim, J. S., Ko, Y. G., Choi, D., Hong, M. K., Jang, Y., Shim, W. H., Cho, S. Y., Kim, B. K., Oh, S., Jeon, D. W., Yang, J. Y., & Jung, J. H. (2010). Incidence and natural history of coronary artery aneurysm developing after drug-eluting stent implantation. American heart journal, 160(5), 987-994. https://doi.org/10.1016/j.ahj.2010.07.013