Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Aug 26, 2024; 16(8): 484-490
Published online Aug 26, 2024. doi: 10.4330/wjc.v16.i8.484
Unloading and successful treatment with bioresorbable stents during percutaneous coronary intervention: A case report
Tao Sun, Ming-Xue Zhang, Yan Zeng, Li-Hua Ruan, Yi Zhang, Cheng-Long Yang, Zhang Qin, Jing Wang, Hai-Mei Zhu, Yun Long
Tao Sun, Ming-Xue Zhang, Li-Hua Ruan, Yi Zhang, Cheng-Long Yang, Zhang Qin, Jing Wang, Yun Long, Department of Cardiology, The First Hospital of Hunan University of Chinese Medicine, Changsha 410007, Hunan Province, China
Yan Zeng, Teaching and Research Section of Chinese Internal Medicine, The First Hospital of Hunan University of Chinese Medicine, Changsha 410007, Hunan Province, China
Hai-Mei Zhu, Department of Pain, The First Hospital of Hunan University of Chinese Medicine, Changsha 410007, Hunan Province, China
Co-first authors: Tao Sun and Ming-Xue Zhang.
Co-corresponding authors: Hai-Mei Zhu and Yun Long.
Author contributions: Sun T and Zhang MX contribute equally to this study as co-first authors. Zhu HM and Long Y contribute equally to this study as co-corresponding authors; Sun T and Zhang MX reviewed the literature and contributed to manuscript drafting; Zeng Y was the patient’s cardiovascular doctor and interpreted the imaging findings; Ruan LH, Yang CL, and Qin Z analyzed and interpreted the imaging findings; Wang J reviewed the literature; Zhu HM and Long Y was responsible for revising the manuscript and for providing intellectual contributions; all authors approved the final version to be submitted.
Supported by Health Commission of Hunan Province, No. 202203014389; Chinese Medicine Research Project of Hunan Province, No. A2023051; and the Natural Science Foundation of Hunan Province, No. 2024JJ9414.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yun Long, MD, PhD, Chief Doctor, Department of Cardiology, The First Hospital of Hunan University of Chinese Medicine, No. 95 Shaoshan Road, Yuhua District, Changsha 410007, Hunan Province, China. wwlyf@126.com
Received: April 30, 2024
Revised: July 4, 2024
Accepted: July 19, 2024
Published online: August 26, 2024
Processing time: 118 Days and 10.6 Hours
Abstract
BACKGROUND

With the development of percutaneous coronary intervention (PCI), the number of interventional procedures without implantation, such as bioresorbable stents (BRS) and drug-coated balloons, has increased annually. Metal drug-eluting stent unloading is one of the most common clinical complications. Comparatively, BRS detachment is more concealed and harmful, but has yet to be reported in clinical research. In this study, we report a case of BRS unloading and successful rescue.

CASE SUMMARY

This is a case of a 59-year-old male with the following medical history: “Type 2 diabetes mellitus” for 2 years, maintained with metformin extended-release tablets, 1 g PO BID; “hypertension” for 20 years, with long-term use of metoprolol sustained-release tablets, 47.5 mg PO QD; “hyperlipidemia” for 20 years, without regular medication. He was admitted to the emergency department of our hospital due to intermittent chest pain lasting 18 hours, on February 20, 2022 at 15: 35. Electrocardiogram results showed sinus rhythm, ST-segment elevation in leads I and avL, and poor R-wave progression in leads V1–3. High-sensitivity troponin I level was 4.59 ng/mL, indicating an acute high lateral wall myocardial infarction. The patient’s family requested treatment with BRS, without implantation. During PCI, the BRS became unloaded but was successfully rescued. The patient was followed up for 2 years; he had no episodes of angina pectoris and was in generally good condition.

CONCLUSION

We describe a case of a 59-year-old male experienced BRS unloading and successful rescue. By analyzing images, the causes of BRS unloading and the treatment plan are discussed to provide insights for BRS release operations. We discuss preventive measures for BRS unloading.

Keywords: Coronary artery diseases; Percutaneous coronary intervention; Bioresorbable stents; Stent unloading; Stent release; Intravascular ultrasound; Case report

Core Tip: Percutaneous coronary intervention plays a vital role in the treatment of coronary artery diseases. Recently, considerable attention has been given to bioresorbable stents (BRS), which can relieve coronary artery occlusions and reduce vascular stenosis. BRS can be absorbed or degraded, which helps restore vascular endothelial function and normalize systolic and diastolic functions. However, reports of clinical cases of BRS-unloading have been limited. Here, we present a case of BRS unloading and successful rescue, providing a practical treatment plan for such clinical scenarios.