Subacute thrombosis after stents implantation in a patient with two adjacent coronary artery aneurysms

Coronary artery aneurysm is an uncommon disease. When it is associated with significantly obstructive coronary artery disease, percutaneous transluminal coronary angioplasty with graft-coated stent implantation usually provides favorable results. Non-coated stents may have the potential risk of thromboembolism. We present a patient with unstable angina who received elective balloon angioplasty and non-coated stent implantations in two adjacent aneurysms. Two episodes of subacute stent thrombosis occurred subsequently at the two different aneurysmal lesions respectively, which were resolved by repeat balloon angioplasty. Post-procedural intravenous heparin infusion is strongly suggested to prevent the development of stent thrombosis. Long-term oral warfarin is also suggested for prophylaxis of recurrent thromboembolic events.