Atheromatous degeneration of the neointima in a bare metal stent: intravascular ultrasound evidence.
We report intravascular ultrasound evidence of a ruptured plaque within a bare metal stent restenosis. In the traditional view, in-stent restenosis is considered to be a benign condition associated with progressive apposition of inert extracellular matrix. The clinical correlate of this pathology would be stable angina. In contrast, recent data have shown that at least one-third of patients with in-stent restenosis present with acute coronary syndromes. This case provides in-vivo evidence that the neointima can undergo atheromatous degeneration and rupture. This matches evidence from recent registries and in-vitro data suggesting that bare metal stent restenosis should not be considered a clinically benign entity.
Fineschi
Massimo
M
U.O. Emodinamica, University Hospital of Siena, Italy.
Carrera
Arcangelo
A
Gori
Tommaso
T
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation; D023903:Coronary Restenosis / Q000000981:diagnostic imaging* / Q000209:etiology; D023921:Coronary Stenosis / Q000628:therapy*; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011474:Prosthesis Design; D012421:Rupture; D015607:Stents; D016896:Treatment Outcome; D017539:Tunica Intima / Q000000981:diagnostic imaging*; D018084:Ultrasonography, Interventional
D008670:Metals; D010975:Platelet Aggregation Inhibitors