CORONARY - Complications
Rebreaking the Invisible Wall: A Case of Recurrent ISR in Minimal Setting
Christian Sunur1, Harry Pribadi1, Steven Setiawan1, Janry Anton Pangemanan1, Agnes Lucia Panda1
Sam Ratulangi University, Indonesia1,
A 55-year-old man came to the emergency room with progressive chest pain over the last 2 days before admission. He was an active smoker with a history of myocardial infarction 5 years ago that was treated with 1 BMS. He had recurrent chest pain 1 year ago and coronary angiography revealed an in stent restenosis in LAD which was treated with POBA, significant stenosis in RCA and LCx that were treated with DES. He had uncontrolled hypertension and dyslipidemia. Hemodynamic was stable on admission.
POBA is not recommended to treat an ISR lesion.IVUS is a mandatory tool to manage ISR complication and to reduce the risk of recurrent ISR.In a minimal setting and lack of resources, the operator’s skill could overcome the lack of microcatheter with careful choice of guiding catheter and wire selections.