How should i treat recurrent restenosis with underexpanded multilayered struts after repeated complex bifurcation stenting?

Akihito Tanaka, Neil Ruparelia, Hiroyoshi Kawamoto, Azeem Latib, Antonio Colombo

Research output: Contribution to journalReview articlepeer-review

Abstract

BACKGROUND: A 68-year-old male, with a history of repeat percutaneous intervention for the treatment of severe calcific stenosis of the left circumflex artery and obtuse marginal branch bifurcation, presented with stable angina at a local hospital. He was found to have recurrent in-stent restenosis of this lesion and subsequently underwent a fifth reintervention; however, adequate balloon dilatation was not achievable in spite of non-compliant and cutting balloon use. In view of continuing symptoms despite optimal medical therapy, the patient was transferred to our hospital for further management. INVESTIGATION: Coronary angiography, intravascular ultrasound. DiAGNOSIS: Recurrent in-stent restenosis following prior repeat complex bifurcation stenting. MANAGEMENT: Rotational atherectomy of the multilayered stent struts, followed by successful balloon dilatation with a cutting balloon at high pressure, and treatment with a drug-coated balloon.

Original languageEnglish (US)
Pages (from-to)1795-1798
Number of pages4
JournalEuroIntervention
Volume12
Issue number14
DOIs
StatePublished - Feb 2017
Externally publishedYes

Keywords

  • Bifurcation
  • Calcification
  • In-stent restenosis
  • Rotational atherectomy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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