JACC. Case reports · 2025
The "Mushroom Sign": An Interesting Case Report of Extreme Stent Malapposition.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Zormpas Georgios, Zioutas Dimitrios, Mitsiadis Sotirios, Boulmpou Aristi, Boulmpos Christos, Vassilikos Vassilios, Papadopoulos Christodoulos
Аннотация
BACKGROUND: Late stent malapposition (LSM) is a recognized phenomenon that can lead to adverse clinical outcomes, including stent thrombosis and restenosis. Optical coherence tomography (OCT) offers high-resolution imaging, aiding in the diagnosis and management of LSM during complex percutaneous coronary interventions.
CASE SUMMARY: A 65-year-old male patient with prior drug-eluting stent implantation in the right coronary artery presented for electrophysiological evaluation because of nonsustained ventricular tachycardia. Coronary angiography revealed mild in-stent restenosis and aneurysmal deformation of the right coronary artery. OCT demonstrated severe stent malapposition with a "mushroom sign," indicating positive vessel remodeling. The malapposed stent was crushed with a noncompliant balloon, followed by implantation of 2 new drug-eluting stents. Postprocedural OCT confirmed successful stent apposition and vessel restoration.
DISCUSSION: This case underscores OCT's value in diagnosing LSM and guiding effective percutaneous coronary intervention in complex lesions.
TAKE-HOME MESSAGE: OCT is indispensable for detecting LSM and optimizing stent placement, improving outcomes in complex coronary interventions.
CASE SUMMARY: A 65-year-old male patient with prior drug-eluting stent implantation in the right coronary artery presented for electrophysiological evaluation because of nonsustained ventricular tachycardia. Coronary angiography revealed mild in-stent restenosis and aneurysmal deformation of the right coronary artery. OCT demonstrated severe stent malapposition with a "mushroom sign," indicating positive vessel remodeling. The malapposed stent was crushed with a noncompliant balloon, followed by implantation of 2 new drug-eluting stents. Postprocedural OCT confirmed successful stent apposition and vessel restoration.
DISCUSSION: This case underscores OCT's value in diagnosing LSM and guiding effective percutaneous coronary intervention in complex lesions.
TAKE-HOME MESSAGE: OCT is indispensable for detecting LSM and optimizing stent placement, improving outcomes in complex coronary interventions.