Drug-Coated Balloon Treatment of Very Late Stent Thrombosis Due to Complicated Neoatherosclerosis

Abstract

We describe the treatment of a patient presenting with very-late stent thrombosis with the use of a drug-coated balloon. In this patient, optical coherence tomography disclosed that ruptured and complicated neoatherosclerosis was the underlying substrate responsible for the episode of very-late stent thrombosis. The potential use of drug-coated balloons in this unique scenario is discussed.

Failure of drug-coated balloon angioplasty to treat bare metal in-stent restenosis accompanied by late stent thrombosis but successful treatment of binary in-stent restenosis

“…This indicates that DCB may not be fully effective in STEMI with high thrombus burden and that DCB may be useful for treating ISR with thrombosis. In a previous case report about the treatment of a patient presenting with very late ST with the use of a DCB, DCB angioplasty might be effective and considered in treatment for very late ST as a result of neoatherosclerosis [10]. In our case, both excessive neointimal proliferation in the distal stent and incomplete neointimal healing with a massive thrombus in the proximal stent were observed when LST occurred.…”

Vulnerable neoatherosclerosis in coronary artery with whole circumference showing intravascular echo attenuation

“…DCB use markedly inhibits late neointimal formation. A previous study demonstrated how DCB potentially provides an attractive therapeutic strategy for neoatherosclerosis . However, another study reported that neoatherosclerosis can develop after DCB treatment for ISR …”