IMAGING AND PHYSIOLOGIC LESION ASSESSMENT - Imaging: Intravascular
Optical Coherence Tomography Guided Angioplasty in a Patient with In-stent Re-stenosis
Debdatta Bhattacharyya1, Saurabh Dhumale1
NH-Rabindranath Tagore International Institute of Cardiac Sciences, India1,
This 62-year-old gentleman who had a PTCA with a 3X24mm paclitaxel eluting stent in 2011, had poor risk factor control, which resulted in diffuse ISR with complete occlusion of stent. Fortunately, LV function was relatively preserved due to development of collaterals from the RCA and Circumflex arteries. Diffuse ISR is a difficult condition to treat and requires good understanding of the underlying cause. OCT rendered excellent images in this case, demonstrating neo-atherosclerosis, stent under-sizing, spotty calcification & neo-vascularization. It helped in the decision making regarding the choice of proximal and distal landing zones diameter of the new stent and optimal stent expansion.