Treatment of a Rare Vascular Complication of Coronary Stenting in an Octagenarian

The ability of drug-eluting stent (DES) to inhibit intimal proliferation has resulted in a massive increase in their usage over the years. However, it is known that the application of DES can alter the normal cascade of vascular healing, resulting in delayed endothelialisation with risk of vascular complications. Coronary artery aneurysms (CAN) are defined as more than 50% dilatation of the coronary artery compared to the reference vessel diameter with the reported incidence after percutaneous intervention (PCI) being only around 0.35 to 6.0%. Previously, CAN had been reported with the use of bare metal stent secondary to stretch, stent fracture and dissection. However, recently, increasing number of cases have been reported describing CAN after DES implantation. To the best of the authors' knowledge, they present the first case from Pakistan of a left anterior descending coronary artery aneurysm after DES implantation treated successfully with stenting under intravascular ultrasound guidance.