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The article discusses a research study on findings in optical coherence tomography (OCT) of lesions in peri-stent contrast staining (PSS) after having a sirolimus-eluting stent implantation. Researchers observed lesions after the OCT with percutaneous coronary intervention in 122 in-stent retinosis (ISD) following an implantation of SES. Conclusions indicated the close association of PSS with OCT findings including incomplete stent apposition and multiple interstrut hollows (MIH) following SES.

Abstract: A 48-year old man was admitted to our hospital because of chest pain 20 months after sirolimus-eluting stent implantation to his left anterior descending coronary artery. A coronary angiogram showed a thrombosis of the stented segment, which was successfully treated with bare-metal stent implantation. One month later, optical coherence tomography (OCT) demonstrated late-acquired incomplete stent apposition (ISA) in the stented segment. Additional dilatation was performed using a 4.5mm balloon. Eleven months later, OCT and intravascular ultrasound images revealed recurrent ISA as a result of progressive vessel remodeling. Serial observation of the stented segment with late-acquired ISA is necessary to understand the natural course of late-acquired ISA and to establish a therapeutic strategy for late-acquired ISA after drug-eluting stent implantation. [Copyright &y& Elsevier]

Summary: Late adverse events including late stent thrombosis and late catch-up phenomenon after percutaneous coronary intervention have been a serious clinical problem in the drug-eluting stent era. Recently, peri-stent contrast staining, namely extension of incomplete stent apposition was reported following drug-eluting stent implantation. Here, we report a case of late incomplete stent apposition with late stent restenosis 3 years after sirolimus-eluting stent implantation. We evaluated this restenotic site by intravascular ultrasound (IVUS) and optical coherence tomography (OCT). Though IVUS demonstrated irregular structure within stent at the stenotic site, OCT detected unusual bell-shaped image of late stent restenosis with extension of incomplete stent apposition. [Copyright &y& Elsevier]