BACKGROUND: A 63-year-old man presented with class II anginal symptoms. INVESTIGATIONS: Cardiac catheterization, intravascular ultrasound (IVUS) virtual histology, optical coherence tomography and off-line palpography. DIAGNOSIS: The patient was diagnosed as having a culprit lesion in the left circumflex artery and a vulnerable plaque in the left anterior descending artery. MANAGEMENT: The culprit lesion was treated with two overlapping drug-eluting stents. The vulnerable plaque was then treated with a self-expanding stent tailored to shield vulnerable plaques (vProtect Luminal Shield). After dilatation of the stent with a low-pressure balloon, IVUS and optical coherence tomography showed excellent apposition of the stent to the vessel wall, with no signs of tissue prolapse or edge dissections. At the 6-month follow-up appointment, the stent showed complete tissue coverage without signs of in-stent restenosis. CONCLUSIONS: Six months of follow-up has demonstrated that a patient with an IVUS-derived, thin capped fibroatheroma was successfully treated with a stent tailored to shield vulnerable plaques.

doi.org/10.1038/nrcardio.2009.34, hdl.handle.net/1765/24588
Nature Reviews Cardiology
Erasmus MC: University Medical Center Rotterdam

Ramcharitar, S., Gonzalo, N., van Geuns, R. J., Garcia-Garcia, H., Wykrzykowska, J., Ligthart, J., … Serruys, P. (2009). First case of stenting of a vulnerable plaque in the SECRITT I trial-the dawn of a new era?. Nature Reviews Cardiology, 6(5), 374–378. doi:10.1038/nrcardio.2009.34