LINC2020 Tatsuya Nakama MD. · Speaker name: Tatsuya Nakama MD. I have the following potential...
Transcript of LINC2020 Tatsuya Nakama MD. · Speaker name: Tatsuya Nakama MD. I have the following potential...
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Monitoring result of angiographic and intravascular imaging devices from aneurysmal degeneration to femoropopliteal
artery occlusion following PB-DES implantation
Tatsuya Nakama MD.Department of Cardiology,
Tokyo Bay Medical Center, Urayasu, Japan
LINC2020
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Speaker name: Tatsuya Nakama MD.
I have the following potential conflicts of interest to report:
Consulting: Boston Scientific, Century Medical Inc., Medtronic
Employment in industry: None
Stockholder of a healthcare company: None
Owner of a healthcare company: None
Honoraria recieved from: Abbot Vascular, Asahi Intecc., Boston Scientific, COOK, Cordis,
NIPRO, KANEKA, Lifeline, Medikit, Medtronic, Orbus Neichi, Terumo,
Disclosure
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BackgroundThe Eluvia (Boston Scientific, MN, USA) polymer-based paclitaxel-eluting nitinolstents (PB-PESs) has shown favorable durability in recent clinical trials. However,aneurysmal degeneration (AD) has been identified on duplex ultrasound (DUS)after PB-PES implantation1. The long-term impact of AD remains unclear.
87%Lesion length 20±12cm
Calcium 42%, CTO 79%
5 cases Aneurysmal change
T Bisdas et al. JACC Cardiovasc Interv. 2018
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80s male underwent both PB-DES & IWS implantation
Pre Post
SUPERA5.5x100
Eluvia 7.0x1207.0x120
Eluvia 7.0x120
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3 Follow-up DUS showed “AD”
Admission for FU・DUS (again)・Angiogram・Imaging device
IVUSOFDIEndoscopy
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No-stent mal-apposition was observed
No AD?
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IVUS findings also showed “Nothing”
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OFDI findings also showed “Nothing”
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Endoscopic findings showed
“Almost perfect epithelialization”
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3 month FU result is completely different BNS
Eluvia 7.0x120, 3M FUHalo sign was observed in DUS, but no aneurysmal changes
SUPERA 5.5x100, 3M FUComplete epithelializationOverlap point: no neointima
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Aneurysmal degeneration was observed, but OFDI and Angioscopic finding were similar to coronary DES
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Conclusion• we speculate that AD after PE-PES implantation may not cause
stent mal-apposition, which is a risk factor for stent thrombosis.
• Although AD was observed after PB-drug eluting stent implantation, the stent strut apposition and epithelialization appeared almost perfect.
• Therefore, AD may not be a risk of stent thrombosis itself.
• However, this is only one case report. Accumulation of clinical experiences and evidences should be need.
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Thank you for your attention
Tatsuya Nakama MDDepartment of Cardiology,
Tokyo Bay Medical Center, Urayasu, Japan
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Monitoring result of angiographic and intravascular imaging devices from aneurysmal degeneration to femoropopliteal
artery occlusion following PB-DES implantation
Tatsuya Nakama MD.Department of Cardiology,
Tokyo Bay Medical Center, Urayasu, Japan
LINC2020