1. Extremely Late Catch-Up Phenomenon After First-Generation Sirolimus-Eluting Stent in the Left Main Stem

    Extremely Late Catch-Up Phenomenon After First-Generation Sirolimus-Eluting Stent in the Left Main Stem

    A 72-year-old man had undergone angioplasty of the left main stem (LMS) with an implantation of a first-generation drug-eluting stent (DES) (3.5 × 18-mm Cypher stent, Cordis, Johnson & Johnson, Bridgewater, New Jersey) ( Figure 1A ). Post-procedural intravascular ultrasound (IVUS) had shown a well-expanded stent ( Figures 1A′ and 1Aa–c ). Four years later, both angiography and IVUS exhibited no significant in-stent restenosis (ISR) or stent recoil ( Figures 1B, 1B′, and 1Ba′–c′ ). At 7 years, he presented with acute coronary syndrome (ACS) while still on long-term dual antiplatelet therapy. A subsequently obtained coronary angiogram exhibited severe ISR at the midshaft of LMS ...

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