Treatment of Drug-Eluting Stent In-Stent Restenosis Using Drug-Eluting Balloon

- Operator : Seung-Jung Park

Treatment of Drug-Eluting Stent In-Stent Restenosis Using Drug-Eluting Balloon
- Operator: Seung-Jung Park, MD

This 64-year-old gentleman received Promus stent 2.75*28mm at dLM to pLCx one year ago. He did not have any symptom. Electrocardiogram was normal and echocardiogram showed normal LV ejection fraction without regional wall motion abnormalities. However, follow-up of coronary angiogram showed tight in-stent restenosis at the LCX ostium (Figure 1). The optimal treatment for the DES ISR still has been challenging. Operator chose the drug eluting balloon, Sequent Please to treat this patient, based on the excellent result of clinical trial. Operator selected 8Fr JL3.5 guiding catheter to engage LMCA and inserted a 0.014 inch BMW wire into the LCX. Intravascular ultrasound was initially performed, showed that extensive tissue growing with tight stenosis at the ostial part of LCx stent (Figure 2). He applied cutting balloon inflation (2.5*10mm) with 6atm and sequentially Dura Star3.0*15mm with 20atm up to 25atm (Figure 3, Figure 4). Finally, Drug-eluting balloon, Sequent Please 3.0*15mm was inflated over 30 seconds (Figure 5). The final result was excellent (Figure 6).

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