Revascularization of malignant coronary instent restenosis resulting from Takayasu's arteritis using sirolimus-eluting stents.

A 37 year-old female who had suffered from arteritis for 20 years underwent a Bentall operation. Since severe stenosis was observed in her left main coronary artery (LMCA) the following year, a minimally invasive direct coronary artery bypass (MIDCAB) operation was performed. Unfortunately, she again complained of angina about 6 months after the second surgery and coronary angiography (CAG) revealed that her left internal thoracic artery graft was totally occluded. Although a 4.0 x 15 mm S670 stent was placed in her LMCA, the LMCA re-stented every 3 months and she underwent reintervention 8 times. We placed 2 sirolimus-eluting stents for treating the LMCA using the culottes stenting technique. CAG 6 months after the index procedure showed no stenosis at her LMCA. Sirolimus-eluting stents were effective for treating stenosis resulting from arteritis as well as that caused by atherosclerosis.