The potential of surgical strategy for incomplete stent apposition after implantation of a sirolimus eluting stent.

Sirolimus-eluting stents (SES) had been implanted in the left anterior descending artery of a 77-year-old male. Three years later, he was admitted for ST elevation myocardial infarction caused by stent thrombosis accompanied with incomplete stent apposition (ISA), and balloon angioplasty had to be performed on him. However, 6 months later, he was admitted for angina. There was progression of ISA and severe stenosis. Considering the allergic reaction to the polymer of the SES, or the risk of future stent thrombosis, coronary artery bypass grafting was selected for the revascularization. One year after the procedure, he felt no symptoms and the bypass graft was patent. A surgical strategy may be considered for recurrence of coronary events accompanied with ISA after stent implantation.