1. Multiple Mechanisms in 1 In-Stent Restenosis Assessed by Optical Coherence Tomography

    Multiple Mechanisms in 1 In-Stent Restenosis Assessed by Optical Coherence Tomography

    A 65-year-old male patient was admitted due to unstable angina . The patient had received percutaneous coronary intervention with 2 overlapping Taxus paclitaxel-eluting stents (Boston Scientific, Natick, Massachusetts) (3.5 × 32 mm and 3.0 × 32 mm) for his left anterior descending coronary artery long lesion 7 years ago. Coronary angiography showed left anterior descending coronary artery total occlusion since the previous first stent ( Figure 1A ). After wiring and balloon pre-dilatation, we opened the lesion ( Figure 1B ) and used optical coherence tomography (OCT) (St. Jude, Westford, Massachusetts) to check the causes of in-stent restenosis (ISR) ( Figure 1C ). Three coexisting putative causes ...

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