Everolimus eluting stent for critical left main stenosis in Takayasu arteritis

Management of Takayasu arteritis (TA) of the left main coronary artery (LMCA) is difficult, because of the possibility of restenosis. Few studies have reported that management of stenotic lesions of the LMCA with stenting and de novo stenting is safe and effective for patients with TA. We report a patient of TA with dilated cardiomyopathy and critical LMCA stenosis. The patient's occluded subclavian artery and the active inflammatory process of TA precluded coronary artery bypass grafting with the use of arterial grafts. Therefore, a drug-eluting stent (DES) was placed in the unprotected left main artery. This procedure resulted in the resolution of symptoms, with a patent stent and no new coronary lesions observed on 3-month angiography, and improved left ventricular function on 6-month echocardiography. Thus, percutaneous coronary intervention (PCI) with a DES for patients with significant coronary involvement secondary to TA is an effective and an alternative treatment when coronary bypass grafting is not an option.