sirolimus and Takayasu-Arteritis

A 52-year-old woman with Takayasu arteritis developed acute coronary syndrome and received percutaneous coronary intervention (PCI). The patient experienced restenosis three times even with drug-eluting stent (DES) implantation. We started steroid administration after the fourth PCI to reduce inflammation due to autoimmunity. With DES and a steroid combination, the patient remained free of chest pain, and a follow-up angiography demonstrated good patency of the stent site. Since in-stent restenosis may result from a complicated combination of neointimal proliferation and autoimmune mechanisms, physicians should consider a combination of DES and a steroid for the treatment of coronary artery disease in Takayasu arteritis.

Topics: Angioplasty, Balloon, Coronary; Coronary Angiography; Coronary Restenosis; Drug-Eluting Stents; Female; Humans; Middle Aged; Neointima; Sirolimus; Steroids; Takayasu Arteritis; Tomography, X-Ray Computed

Topics: Adult; Angioplasty, Balloon, Coronary; Coronary Angiography; Drug-Eluting Stents; Electrocardiography; Female; Follow-Up Studies; Humans; Immunosuppressive Agents; Myocardial Infarction; Sirolimus; Takayasu Arteritis

We describe a 66-year-old woman with aortitis syndrome, successfully treated with percutaneous coronary intervention using sirolimus-eluting stent (SES) for ostial stenosis of left main coronary artery after Bentall operation. At one-year follow-up, she had no evidence of restenosis and no clinical events. Stent implantation with SES may be useful for ostial left main coronary stenosis after Bentall operation in selected patients with aortitis syndrome.

Topics: Aged; Coronary Angiography; Coronary Stenosis; Drug-Eluting Stents; Female; Humans; Postoperative Complications; Prosthesis Implantation; Sirolimus; Takayasu Arteritis

We report on a patient with Takayasu's arteritis with coronary artery involvement who developed late stent malapposition 2 years after drug eluting stent implantation in the left anterior descending artery. Due to progression of the aneurysm on angiographic follow up, a covered stent was deployed. Problematic aspects of percutaneous coronary interventions in these patients are discussed.

Topics: Adult; Angioplasty, Balloon, Coronary; Coronary Aneurysm; Coronary Artery Disease; Coronary Restenosis; Drug-Eluting Stents; Female; Humans; Immunosuppressive Agents; Radiography; Sirolimus; Takayasu Arteritis

Topics: Adult; Angioplasty, Balloon, Coronary; Coronary Angiography; Coronary Stenosis; Female; Humans; Immunosuppressive Agents; Paclitaxel; Sirolimus; Stents; Takayasu Arteritis; Treatment Outcome

A 37 year-old female who had suffered from arteritis for 20 years underwent a Bentall operation. Since severe stenosis was observed in her left main coronary artery (LMCA) the following year, a minimally invasive direct coronary artery bypass (MIDCAB) operation was performed. Unfortunately, she again complained of angina about 6 months after the second surgery and coronary angiography (CAG) revealed that her left internal thoracic artery graft was totally occluded. Although a 4.0 x 15 mm S670 stent was placed in her LMCA, the LMCA re-stented every 3 months and she underwent reintervention 8 times. We placed 2 sirolimus-eluting stents for treating the LMCA using the culottes stenting technique. CAG 6 months after the index procedure showed no stenosis at her LMCA. Sirolimus-eluting stents were effective for treating stenosis resulting from arteritis as well as that caused by atherosclerosis.

Topics: Adult; Coronary Angiography; Coronary Artery Bypass; Coronary Disease; Coronary Restenosis; Coronary Vessels; Female; Humans; Sirolimus; Stents; Takayasu Arteritis

A 53-year-old woman with Takayasu arteritis was admitted to hospital because of worsening exertional angina. Coronary angiography revealed 90% ostial stenosis in the left main coronary artery (LMCA), which also involved the bifurcation of the relatively short LMCA. Because the patient refused coronary bypass surgery, she underwent percutaneous coronary intervention (PCI) and the stenosis was successfully dilated. However, the exertional angina recurred a few months later and again after the second PCI. Finally, a sirolimus-eluting stent was deployed in the in-stent restenotic lesion. The patient has been free from angina pectoris for 6 months after the last PCI and follow-up coronary angiography indicated no restenosis in the LMCA.

Topics: Angioplasty, Balloon, Coronary; Coronary Restenosis; Female; Humans; Middle Aged; Radiography; Sirolimus; Stents; Takayasu Arteritis