Pathological Perspective of Drug-Eluting Stent Thrombosis
Figure 4
(a) These angiograms demonstrated that the SES stented site showed a tendency toward irregularly shaped coronary ectasia (peri-stent contrast staining; PSS) and finally saccular aneurysm formation 2 years after SES implantation, followed by VLST 3 months later. (b) Pathological examination demonstrated focal strut malapposition with aneurysmal dilatation and partially occlusive mural thrombus. (c) In addition, extensive inflammation, consisting primarily of lymphocytes and eosinophils, with a focal giant cell reaction, was evident at the stented site. An asteroid body with intense foreign body granulomatous inflammation was also visible (arrow). Such localized hypersensitivity vasculitis existed primarily around the struts and extended to the intima and adjoining media and adventitia.
