Author/Authors :
Koutouzis, Michael Cardiology Department - Hellenic Red Cross Hospital of Athens, Athens, Greece , Agelaki, Maria Cardiology Department - Hellenic Red Cross Hospital of Athens, Athens, Greece , Maniotis, Christos Cardiology Department - Hellenic Red Cross Hospital of Athens, Athens, Greece , Tsiafoutis, Ioannis Cardiology Department - Hellenic Red Cross Hospital of Athens, Athens, Greece , Patris, Vasileios Cardiac Surgery Department - Evaggelismos General Hospital, Athens, Greece , Argyriou, Mihalis Cardiac Surgery Department - Evaggelismos General Hospital, Athens, Greece
Abstract :
A middle age woman with known ischemic heart disease and old stents in proximal left anterior descending coronary artery (LAD)
was admitted to Coronary Care Unit with acute coronary syndrome. The coronary angiography showed one vessel disease with
significant restenosis within the previously implanted stents. The lesion was tough and remained undilatable despite high pressure
balloon inflation. Eventually, the balloon ruptured creating a massive dissection of the LAD beginning immediately after the distal
part of the undilatable lesion. We proceeded with a challenging ad hoc rotational atherectomy of the lesion and finally stenting of
the lesion. In-stent restenosis many years after stent implantation is considered to be mainly due to neoatheromatosis compared to
intimal hyperplasia, making lesion treatment more difficult and unpredictable.
