Cor Vasa 2023, 65(6):877-879 | DOI: 10.33678/cor.2023.021

Coronary evagination after self-apposing stent deployment: a rare but possible event. A clinical case at 4-year follow-up

Giuseppe Venuti^a, Francesca Consolo^b, Claudia Morabito^a, Alice Moncada^b, Olga La Cognata^b, Rosalba De Sarro^b, Alessandro Di Carlo^b, Armando Lo Savio^b, Marco Cerrito^a

^a Department of Cardiothoracic and Vascular Science, Division of Cardiology, Papardo Hospital, Messina, Italy

^b Department of Clinical and Experimental Medicine, University of Messina, Italy

Background: Coronary evagination is a coronary abnormality that has been associated with poor long-term outcomes irrespective of the presence of concomitant coronary artery disease (CAD). Its pathogenesis is still not well understood; intracoronary manipulation and percutaneous coronary intervention (PCI) are considered predictors of coronary enlargement through mechanism such as prolonged inflammation, suboptimal endothelialization and vessel positive remodeling. Some stent platforms, like self-apposing stents, seem to be more involved, causing more vessel remodeling. Case presentation: We report the case of a 79-year-old woman who underwent percutaneous coronary intervention (PCI) because of effort angina pectoris; we used a self-apposing stent in a slightly ectatic segment of left circumflex artery and a conventional stent to treat another lesion, with good results. Four years later, a coronary angiography showed an aneurysm surrounding previously implanted self-apposing stent platform; anyway, the coronary flow was normal, so no further intervention was required.

Conclusions: To the best of our knowledge, this is the first paper considering the implication of self-apposing stent properties in evagination generation; this clinical case can be useful to pay attention to patients who underwent percutaneous coronary intervention and received this type of stent.

Keywords: Coronary angiography, Coronary evagination, Self-apposing stent

Received: March 9, 2023; Revised: March 9, 2023; Accepted: March 16, 2023; Prepublished online: June 2, 2012; Published: December 22, 2023  Show citation