title: Neointimal tissue healing patterns after paclitaxel-eluting balloon treatment of in-stent restenosis: optical coherence tomography and intravascular ultrasound insights.
abstract: An 80-year-old patient presented with severe in-stent restenosis of an everolimus-eluting stent implanted in the left anterior descending coronary artery 3 years previously. We obtained good angiographic result after paclitaxel-eluting balloon dilation. However, on optical coherence tomography (OCT), multiple, angiographically silent, in-stent, and edge-related dissections were readily recognized. Intravascular ultrasound (IVUS) revealed residual neointima with minor disruptions. At 9-month follow-up, an excellent angiographic result was demonstrated with complete resolution of the stent-related dissections on OCT. IVUS and OCT confirmed complete neointimal healing with a larger lumen. This case illustrates the value of OCT and IVUS to provide unique insights on the pathophysiological mechanisms and healing patterns of paclitaxel-eluting balloon treatment of in-stent restenosis.
authors.affiliation: Interventional Cardiology, Cardiovascular Institute, Clínico San Carlos University Hospital, IdISSC, Madrid, Spain. falf@hotmail.com
authors.forename: Jorge
authors.initials: J
authors.lastname: Sandoval
authors.forename: Miguel
authors.initials: M
authors.lastname: Medina
authors.forename: Fernando
authors.initials: F
authors.lastname: Alfonso
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D054855:Drug-Eluting Stents; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D058426:Neointima / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology; D017239:Paclitaxel; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D014945:Wound Healing / Q000502:physiology*
chemical_list: D017239:Paclitaxel