First case of stenting of a vulnerable plaque in the SECRITT I trial-the dawn of a new era?

Background. a 63-year-old man presented with class II anginal symptoms. Investigations. cardiac catheterization, intravascular ultrasound (IVus) virtual histology, optical coherence tomography and off-line palpography. Diagnosis. the patient was diagnosed as having a culprit lesion in the left circumflex artery and a vulnerable plaque in the left anterior descending artery. Management. the culprit lesion was treated with two overlapping drug-eluting stents. the vulnerable plaque was then treated with a self-expanding stent tailored to shield vulnerable plaques (vProtect (R) Luminal shield). after dilatation of the stent with a low-pressure balloon, IVus and optical coherence tomography showed excellent apposition of the stent to the vessel wall, with no signs of tissue prolapse or edge dissections. at the 6-month follow-up appointment, the stent showed complete tissue coverage without signs of in-stent restenosis. Conclusions. six months of follow-up has demonstrated that a patient with an IVUS-derived, thin capped fibroatheroma was successfully treated with a stent tailored to shield vulnerable plaques.