A case of Takayasu arteritis with repeated coronary artery restenosis after drug-eluting stent implantation successfully treated with a combination of steroids.

Abstract

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.

• Authors: Katsuaki Yokota, Masahisa Shimpo, Tomohiko Iwata, Masahiro Hirose, Tomokazu Ikemoto, Ken-ichi Ohya, Takaaki Katsuki, Kazuyuki Shimada, Kazuomi Kario
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 51 Issue 7 Pg. 739-43 ( 2012) ISSN: 1349-7235 [Electronic] Japan
• PMID: 22466830 (Publication Type: Case Reports, Journal Article)

Chemical References

• Steroids
• Sirolimus

Topics

• Angioplasty, Balloon, Coronary
• Coronary Angiography
• Coronary Restenosis (diagnostic imaging, drug therapy, therapy)
• Drug-Eluting Stents
• Female
• Humans
• Middle Aged
• Neointima (diagnostic imaging)
• Sirolimus (administration & dosage)
• Steroids (administration & dosage, therapeutic use)
• Takayasu Arteritis (diagnostic imaging, drug therapy, therapy)
• Tomography, X-Ray Computed