Calcified In-Stent Restenosis

Alfonso, Fernándo; Sandoval, Jorge; Nolte, Christian

doi:10.1161/circinterventions.111.966606

Cited by 35 publications

(14 citation statements)

References 4 publications

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“…In our data, the appearance of calcified neointima was closely dependent on the time from the implantation, suggesting that it takes ≈6 years to develop a calcified neointima. Stent ages in the previous case reports were 8 and 10 years, 18,19 which were consistent with our data. In the native coronary artery, intimal calcification develops in the second decade of life, and the prevalence increases over time.…”

Section: Stent Age and Nasupporting

confidence: 92%

“…7,9,10 In the present study, we identified 8 calcified neointima (4.5%) of 179 stents. Although 2 case reports with intravascular ultrasound and OCT have been published, 18,19 there has been no systematic study showing the presence and clinical significance of calcified neointima. In our data, the appearance of calcified neointima was closely dependent on the time from the implantation, suggesting that it takes ≈6 years to develop a calcified neointima.…”

Section: Stent Age and Namentioning

confidence: 99%

“…In a previous study in which tissue property analysis was performed, the stents with neointimal hyperplasia ≤100 µ were excluded because even the analysis software could not accurately analyze the tissue property signals. 19 Third, 4 types of DESs, including SES, PES, ZES, and EES, were included in the present study. Because of the relatively small number of each DES subtype and lack of long-term follow-up data of second generation DES, we could not precisely evaluate the difference in the nature of NA among the subtypes of DES.…”

Section: Limitationsmentioning

confidence: 99%

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Predictors for Neoatherosclerosis

Yonetsu

Katô

Kim

et al. 2012

Circ: Cardiovascular Imaging

149

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Optical coherence tomography (OCT) is an emerging intracoronary diagnostic modality that provides high-resolution images of coronary artery in vivo. 11 In addition to tissue characterization in native coronary plaques, OCT has been applied to characterize neointima after stent implantation. 12 Indeed, several OCT studies revealed the development of lipid-laden neointima inside the stents, and OCT has become the modality of choice to study atherosclerotic change of neointima. 7,9,10 Background-Recent studies have reported development of neoatherosclerosis (NA) inside the stents several years after stent implantation. The aim of this study was to determine the predictors for NA using optical coherence tomography. Methods and Results-From a total of 1080 patients who underwent optical coherence tomography, we identified 179 stents in 151 patients in which the mean neointimal thickness was >100 µm. The presence of lipid-laden neointima or calcification inside the stents was defined as NA in the present study. Patient characteristics, stent type, and time since stent implantation (stent age) were compared between stents with or without NA.

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Section: Stent Age and Nasupporting

confidence: 92%

Section: Stent Age and Namentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

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Predictors for Neoatherosclerosis

Yonetsu

Katô

Kim

et al. 2012

Circ: Cardiovascular Imaging

149

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“…7, 8 We recently reported a patient with undilatable calcified ISR who experienced several episodes of balloon rupture despite the use of non-compliant balloons. 7 Eventually rotational atherectomy was required to dilate the calcified tissue causing ISR and to obtain an optimal final result. In that patient, the combined use of OCT and IVUS was instrumental in identifying the calcified tissue within the stent and to optimize final results.…”

Section: Disclosuresmentioning

confidence: 99%

“…Interestingly, when a new stent is implanted OCT is able to identify the presence of residual calcified tissue between the 2 stent layers. 7 OCT is of great value in detecting dissections at the stent edge (frequently angiographically silent), and recent data suggest that these dissections may be associated with adverse clinical outcomes. 9-11 OCT may also identify intra-stent dissections but its value in visualizing abluminal dissections in patients presenting with ISR remains unclear.…”

Section: Disclosuresmentioning

confidence: 99%

Peri-Stent Abluminal Hematoma and Pin-Hole Balloon Rupture During Treatment of Calcified Drug-Eluting Stent In-Stent Restenosis

Martín

Cárdenas

Bañuelos

et al. 2013

Circ J

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Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp vascular ultrasound (IVUS) provided unique morphological insights and facilitated identification of the calcified underlying substrate of ISR.An 82-year-old man with a previous history of coronary surgery and interventions on the circumflex coronary (LCX) was admitted for prolonged angina, transient electrocardiographic changes on lateral leads and troponin elevation. He had a previous history of cigarette smoking, hypertension, dyslipidemia, arly results of coronary interventions for patients with in-stent restenosis (ISR) are largely satisfactory. 1,2 In this setting lack of initial angiographic success or occurrence of procedural-related complications are exceedingly rare. 1,2 We report a patient presenting with old calcified ISR who experienced a pin-hole balloon rupture and peri-stent abluminal intramural hematoma during a repeated coronary intervention. Optical coherence tomography (OCT) and intra- IMAGES IN CARDIOVASCULAR MEDICINE

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Balloon pin‐hole rupture during percutaneous coronary intervention for recurrent, calcified in‐stent restenosis: A case report

Murata

Takayama

Hiro

et al. 2017

Cathet Cardio Intervent

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Percutaneous coronary intervention (PCI) for patients with in-stent restenosis (ISR) is generally considered safe and effective. However, due to increased tissue hardness, PCI for calcified intra-stent ISR is technically challenging. Here, we report severe angioplasty-related complications in a patient presenting with calcified, recurrent ISR following PCI. After receiving drug-coated balloon (DCB) angioplasty for an initial ISR, the patient developed recurrent ISR during the follow-up period. Intravascular imaging revealed intra-stent calcifications and balloon angioplasty was subsequently performed. During the angioplasty, a pin-hole balloon rupture occurred, consequently causing coronary dissection as visualized by intravascular imaging. To prevent acute coronary occlusion, stent implantation was required. The present case report suggests that, following detection of intra-stent calcified stenosis, both careful balloon inflation as well as optimal ablation device selection are required to prevent potential complications and obtain successful procedural outcomes.

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Calcified In-Stent Restenosis

Cited by 35 publications

References 4 publications

Predictors for Neoatherosclerosis

Predictors for Neoatherosclerosis

Peri-Stent Abluminal Hematoma and Pin-Hole Balloon Rupture During Treatment of Calcified Drug-Eluting Stent In-Stent Restenosis

Balloon pin‐hole rupture during percutaneous coronary intervention for recurrent, calcified in‐stent restenosis: A case report

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