Everolimus
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Peri-stent contrast staining enlargement in saphenous vein graft: case report An approximately 51-year-old woman exhibited peri-stent contrast staining (PSS) enlargement in saphenous vein graft (SVG) during antiproliferative treatment with everolimus. The woman, who had undergone Bentall and hemiarch replacement due to severe aortic regurgitation, was diagnosed with Takayasu arteritis at the age of 47 years. Therefore, she started receiving unspecified steroid therapy. After 2 years, she developed exertional angina, and a pseudo-aneurysm of the left coronary button was observed on coronary computed tomography angiography (CCTA). Therefore, she underwent an excision and aortocoronary bypass grafting with SVG to the left main trunk. Within 2 months, she was hospitalised again due to ventricular fibrillation. Subsequent coronary angiography (CAG) showed total SVG occlusion due to a massive organised thrombus. Therefore, she underwent implantation of everolimus-eluting stent [route and dosage not stated]. Intravascular ultrasound (IVUS) demonstrated sufficient stent expansion. At discharge, CCTA showed good patency of SVG. However, after 2 years (at the age of ~51 years), a follow-up CAG showed PSS. IVUS indicated a stent malapposition and positive remodeling of SVG. Also, CCTA showed that the contrast media extended around the stent. At 4-year follow-up, CAG showed an advanced PSS expansion, and IVUS and CCTA demonstrated a worsening stent malapposition and an enlargement of SVG aneurysm. The PSS enlargement in SVG was believed to be an abnormal coronary artery wall response to everolimus, released from the drug-eluting stent [outcome of ADR not stated]. Shibata N, et al. Multimodality imaging evaluation of saphenous vein graft peri-stent contrast staining enlargement. International Journal of Cardiovascular Imaging 36: 803519833 2105-2106, No. 11, Nov 2020. Available from: URL: http://doi.org/10.1007/s10554-020-01937-y
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Reactions 12 Dec 2020 No. 1834
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