title: Intravascular ultrasound in patients with challenging in-stent restenosis: importance of precise stent visualization.
abstract: Intravascular ultrasound (IVUS) is widely used to optimize stent (ST) implantation. However, its value to guide therapy in challenging cases of in-stent restenosis (ISR) is not well established. We present 3 patients with complex ISR where IVUS interrogation was useful: (a) to readily identify the ST "entry door," (b) to accurately detect ST malapposition, (c) to measure the extent of ST protrusion out from its deployed position, and (d) to guide and optimize therapy. Thus, due to its unique ability to visualize the complete structure of the underlying ST, IVUS constitutes a superb diagnostic tool in patients with ISR, especially in challenging anatomic settings.
authors.affiliation: Cardiovascular Institute, San Carlos University Hospital, Madrid, Spain. falf@hotmail.com
authors.forename: Fernando
authors.initials: F
authors.lastname: Alfonso
authors.forename: Alfonso
authors.initials: A
authors.lastname: Suárez
authors.forename: Luis
authors.initials: L
authors.lastname: Pérez
authors.forename: Manel
authors.initials: M
authors.lastname: Sabaté
authors.forename: Raul
authors.initials: R
authors.lastname: Moreno
authors.forename: Camino
authors.initials: C
authors.lastname: Bañuelos
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging*; D003922:Diabetes Mellitus, Type 1; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D015607:Stents; D018084:Ultrasonography, Interventional