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(Radiology. 2001;220:142-144.)
© RSNA, 2001

Radiation Oncology

Fatal Late Coronary Thrombosis after Implantation of a Radioactive Stent: Postmortem Angiographic and Histologic Findings—Case Report1

Paul Wexberg, MD, BM, Michael Gottsauner-Wolf, MD, Irene Sulzbacher, MD, Peter Birner, MD, Anton Laggner, MD and Dietmar Glogar, MD

1 From the Department of Cardiology, Clinic for Internal Medicine II (P.W., M.G.W., D.G.), Clinical Department of Pathology (I.S., P.B.), and Department of Emergency Medicine (A.L.), University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria. Received September 5, 2000; revision requested October 18; revision received December 4; accepted December 19. Address correspondence to P.W. (e-mail: paul.wexberg@akh-wien.ac.at).

Postmortem angiography and histologic analysis of a fatal coronary thrombosis 4 months after implantation of a radioactive stent are described. Histologic findings suggested incomplete re-endothelialization in the segment with the stent. Ionizing radiation may delay re-endothelialization after revascularization, thus maintaining the thrombogenicity of the irradiated vessel segment. Thus, prolonged antiplatelet therapy should be considered after intravascular radiation therapy.

Index terms: Angiography, 54.124 • Coronary vessels, stents and prostheses, 54.126 • Coronary vessels, thrombosis, 54.442, 54.47 • Heart, US, 54.1298 • Stents and prostheses, 54.126 • Stents and prostheses, radiation, 54.47 • Thrombosis, arterial, 54.442, 54.47