Coronary angioscopy and optical coherence tomography for confirmation of drug-coated neointimal plaque after paclitaxel-coated balloon angioplasty for in-stent restenosis

A 74-year old man presented recurrent angina pectoris due to in-stent restenosis (ISR) with severely calcified neointima. In-stent neoatherosclerosis (NA) is associated with late stent failure, and NA with calcified neointima occurs in some cases. Because the presence of neointimal calcification could lead to underexpansion of newly implanted stent for ISR, a scoring balloon was selected for predilatation to obtain maximum extrusion of the neointimal plaque and subsequently, an everolimus-eluting stent was implanted. However, moderate stenosis remained on coronary angiography, and optical coherence tomography (OCT) revealed underexpansion of the newly implanted stent because an attempt at balloon dilatation of neointimal calcification failed. Although OCT can clearly discriminate stent struts from neointimal calcification, we did not perform OCT assessment between scoring balloon and stenting. It is highly recommended to confirm whether the lesion is adequately treated by balloon angioplasty before stenting in cases with calcified ISR.

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IRREGULAR SURFACE AND INTRALUMINAL MATERIAL DETECTED BY OPTICAL COHERENCE TOMOGRAPHY IS USEFUL TO PREDICT DISTAL EMBOLISM AFTER CUTTING BALLOON ANGIOPLASTY FOR IN-STENT RESTENOSIS

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(12)60115-6 ◽

2012 ◽

Vol 59 (13) ◽

pp. E114

Author(s):

Masayuki Taniike ◽

Masami Nishino ◽

Naotaka Okamoto ◽

Akihiro Tanaka ◽

Atsushi Kikuchi ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Balloon Angioplasty ◽

Optical Coherence ◽

Irregular Surface ◽

Cutting Balloon ◽

Stent Restenosis ◽

Cutting Balloon Angioplasty ◽

In Stent Restenosis

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Coronary angioscopy and optical coherence tomography for confirmation of drug-coated neointimal plaque after paclitaxel-coated balloon angioplasty for in-stent restenosis

Serial Observations of In-Stent Restenosis Treated With Drug-Coated Balloon Angioplasty by Optical Coherence Tomography and Coronary Angioscopy

P2636Comparison of the efficacy of balloon angioplasty or paclitaxel-coated balloon or stent implantation for in-stent restenosis based on analysis by optical coherence tomography

INITIAL RESULT OF PLAIN OLD BALLOON ANGIOPLASTY FOR IN-STENT RESTENOSIS LESION ACCORDING TO THE TISSUE ASSESSMENT BY OPTICAL COHERENCE TOMOGRAPHY

Effect of neointimal tissue morphology on vascular response to balloon angioplasty in lesions with in-stent restenosis after drug-eluting stent deployment: an optical coherence tomography analysis

TISSUE CHARACTERISTICS OF IN–STENT TISSUE DETECTED BY OPTICAL COHERENCE TOMOGRAPHY MAY AFFECT RE–RESTENOSIS AFTER CUTTING BALLOON ANGIOPLASTY FOR IN–STENT RESTENOSIS

Different Neointimal Pattern in Early vs. Late In-Stent Restenosis and Clinical Outcomes After Drug-Coated Balloon Angioplasty ― An Optical Coherence Tomography Study ―

In-stent tissue characteristics detected by optical coherence tomography may affect re-restenosis after cutting balloon angioplasty for in-stent restenosis

THE EFFECT OF DRUG-COATED BALLOON ANGIOPLASTY FOR IN-STENT RESTENOSIS EVALUATED BY SERIAL ANGIOSCOPY AND OPTICAL COHERENCE TOMOGRAPHY STUDY

Severely Circumferentially Calcified Neointima as a New Cause of Undilatable In-Stent Restenosis

IRREGULAR SURFACE AND INTRALUMINAL MATERIAL DETECTED BY OPTICAL COHERENCE TOMOGRAPHY IS USEFUL TO PREDICT DISTAL EMBOLISM AFTER CUTTING BALLOON ANGIOPLASTY FOR IN-STENT RESTENOSIS

Different Neointimal Pattern in Early vs. Late In-Stent Restenosis and Clinical Outcomes After Drug-Coated Balloon Angioplasty　― An Optical Coherence Tomography Study ―