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Image in Cardiology
Different patterns of in-stent coverage in drug-eluting stents
Diferentes padrões de cobertura intra-stent em stents farmacológicos
Daniele Gemmaa,
Corresponding author
daniele.gemma@hotmail.com

Corresponding author.
, Santiago Jimenez Valeroa, Raúl Moreno Gómeza, Francisco Javier Irazusta Córdobab, Pablo Merás Colungab, José Luis López-Sendónb
a Intervencional Cardiology, Hospital Universitario La Paz, Madrid, Spain
b Cardiology, Hospital Universitario La Paz, Madrid, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 65-year-old man had undergone percutaneous revascularization of the left anterior descending artery four years earlier&#44; with two non-overlapping stents being implanted in the same procedure&#58; a first-generation drug-eluting stent &#40;DES&#41; in the proximal segment &#40;2&#46;75 mm&#215;16 mm TAXUS Element paclitaxel-eluting stent&#41; and a second-generation DES in the mid segment &#40;2&#46;5 mm&#215;24 mm PROMUS Element everolimus-eluting stent&#41;&#46; The patient underwent new coronary angiography for effort angina&#44; which demonstrated diffuse restenosis of the proximal stent&#44; with a 71&#37; obstructive lesion in the mid portion &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>A&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Optical coherence tomography demonstrated two different patterns of in-stent coverage in the two stents&#58; mild proliferation of a homogeneous hyperintense neointima highly suggestive of classic &#40;&#8216;healthy&#8217;&#41; neointimal thickening in the distal stent&#44; with minimal luminal area &#40;MLA&#41; of 3&#46;8 mm<span class="elsevierStyleSup">2</span> &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>C and c&#41;&#59; and a heterogeneous hypointense neointima with low attenuation suggesting an active inflammatory process causing severe restenosis of the TAXUS stent &#40;MLA 2&#46;1 mm<span class="elsevierStyleSup">2</span>&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>B and b&#41;&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Following predilatation&#44; an Absorb everolimus-eluting bioresorbable scaffold &#40;BRS&#41; &#40;Abbott Vascular&#44; CA&#41; was implanted into the proximal stent&#44; with good results &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>D&#41;&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">This case reveals a process of restenosis in a first-generation DES and normal neointimal coverage in a second-generation DES implanted in a single patient and artery in the same procedure&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Initial coronary angiography &#40;A&#44; a&#41; showing diffuse restenosis of the proximal stent and a good late result of the distal stent &#40;arrows&#41;&#59; optical coherence tomography &#40;OCT&#41; demonstrating a heterogeneous hypointensive neointima with a bright superficial layer &#40;arrow&#41; and presence of macrophage infiltration and microvessels &#40;asterisk&#41; into the neointima in the first-generation DES &#40;B and b&#41;&#44; and a homogeneous hyperintensive neointima in the second-generation DES &#40;C and c&#41;&#59; OCT post-stent &#40;D&#41; showing good expansion and apposition of the bioresorbable scaffold&#46;</p>"
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Article information
ISSN: 21742049
Original language: English
DOI:10.1016/j.repce.2017.11.004
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