Home > Journals > Gazzetta Medica Italiana Archivio per le Scienze Mediche > Past Issues > Gazzetta Medica Italiana Archivio per le Scienze Mediche 2016 July-August;175(7-8) > Gazzetta Medica Italiana Archivio per le Scienze Mediche 2016 July-August;175(7-8):344-7

CURRENT ISSUE
 

JOURNAL TOOLS

eTOC
To subscribe
Submit an article
Recommend to your librarian
 

ARTICLE TOOLS

Reprints
Permissions
Cite this article as

 

CASE REPORTS   

Gazzetta Medica Italiana Archivio per le Scienze Mediche 2016 July-August;175(7-8):344-7

Copyright © 2016 EDIZIONI MINERVA MEDICA

language: English

Severe coronary spasm after everolimus-eluting coronary stent implantation

Shigenori ITO, Hiroyuki OHMORI, Tatsuya MIZOGUCHI, Tomoaki SAEKI

Division of Cardiology, Nagoya City East Medical Center, Nagoya, Japan


PDF


A 79-year-old woman underwent implantation of 4 everolimus-eluting stents (total stent length, 60 mm) for a calcified long lesion in the left anterior descending coronary artery. The baseline acetylcholine provocation test was negative. However, she felt chest oppression at rest 3 days after the stent implantation. Although a calcium channel blocker and isosorbide dinitrate resolved the symptom, it recurred after discontinuation of them at another clinic. Acetylcholine provocation test performed 8 months after the stent implantation revealed severe coronary spasm in the left anterior descending coronary artery distal to the stents, which caused hemodynamic collapse even after administration of high-dose isosorbide nitrate, nicorandil, and noradrenalin. Intra-aortic balloon pumping could resolve spasm and hemodynamic collapse. The long stents extending to the distal part of the artery and the high-dose of drug or polymer on the stents might have provoked the spasm despite the used of second-generation stents.

top of page