Left Main Rapamycin-Coated Stent
Invasive Versus Noninvasive Angiographic Follow-Up
A 47-year-old man with a history of recurrent coronary interventions underwent percutaneous coronary intervention (PCI) of the left main coronary artery with implantation of a rapamycin-coated stent (BX Velocity 4.0×18 mm). At 6-month follow-up, with no physical complaints, he underwent conventional and multislice spiral computed tomography (MSCT) coronary angiography.
Intravenously contrast-enhanced MSCT (Siemens Somatom Plus 4 Volume Zoom, Siemens AG) showed a well-positioned stent in the left main coronary artery with no indication of lumen diameter reduction or neointimal hyperplasia (Figure 1). By means of virtual coronary angioscopy, a 3-dimensional reconstructed internal view is provided (Movie I). An animated movie of the volume rendered data offers an external overview of the coronary anatomy and the stent (VoxelView, Vital Images) (Figure 1C, Movie II).
This case illustrates the feasibility of noninvasive angiographic follow-up after PCI. In our experience, however, these results could only be obtained in larger diameter stents.
Movies I and II are available in an online-only Data Supplement available at http://www.circulationaha.org.
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
Circulation encourages readers to submit cardiovascular images to the Circulation Editorial Office, St Luke’s Episcopal Hospital/Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.