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A 71 year old man with a history of limiting stable exertional angina who had required admission for unstable angina on two occasions in the preceding year underwent elective coronary angiography. Risk factors included hypertension, non-insulin dependent diabetes, hypercholesterolaemia, and previous smoking. Angiography showed single vessel disease of the left anterior descending artery (LAD) (top: right anterior oblique 30° caudal 10°). Just distal to the first diagonal there was a discrete coronary aneurysm with a severe stenosis proximally. After pre-inflation with a 2.5 mm balloon a 16 × 3.5 mm JoMed Jostent coronary stent graft was deployed at 18 atm, achieving excellent flow in the LAD and aneurysm obliteration (bottom: right anterior oblique 45° caudal 10°). The patient was discharged on a one month course of clopidogrel and remains asymptomatic at follow up.
The Jostent coronary stent graft is a polytetrafluoethylene (PTFE) stent sandwich ideally suited for treatment of coronary aneurysms, perforations, and fistulae.