Image in interventional cardiovascular medicine - Image 7

Image in Interventional Cardiovascular Medicine: what do you see?

EuroPCR 2015 - An image is worth 1000 words - Image 7


Share your comments on the image above:

  • What do you see?
  • Which diagnosis element do you recognise?
  • How would you treat?

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  • Giuseppe Ando 17 Nov 2016

    18/04/2015 Proximal LAD: focal eccentric 30% in-stent restenosis on panel F, from 4 h to 10 h (likely a previous ISR treated with in-stent stenting and leading to the actual image) Neo-atherosclerosis of the neo-intima: central signal-poor region (Panel F) with central necrosis of the neo-plaque (Panel E and D) and neo-plaque cap rupture with ulceration (panels C and B).

  • Patrick Cassell 17 Nov 2016

    20/05/2015 ISR with neoatherosclerosis/Ruptured plaque. Stented 2x. If this patient has previously been treated with BMS only then a drug eluting balloon may be a good choice as it introduces anti-prolific drug without adding another metal stent. If this patient has previously been treated with 1-2x DES, then a surgical consult would be sought for a second opinion as adding more DES or DEB to a patient who has already failed this form of therapy is unlikely to be successful. Even though DEB is more lipophilic than current DES, I suspect there would be limited patient benefit in this case.