DCB in in-stent restenosis - LIVE Case

A 60-year-old male with hypertension, type II diabetes, and moderately impaired LV function (45%), has a history of LAD PCI treated with three Cypher stents in 2006. He underwent further treatment for LAD in-stent restenosis in 2012, 2020, and 2022 using a new stent and DCB. He recently presented with a STEMI treated by primary PCI on the mid RCA, and the LAD in-stent restenosis was staged.

The long LAD in-stent restenosis was treated with DCB after extensive lesion preparation using cutting and NC balloons, guided by OCT.

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Key moments

• 34:40–53:40 – Cutting balloon
• 56:30–1:01:49 – OCT at each step
• 1:03:20–1:10:34 – DCB deployment

Keywords: Instent restenosis, cutting balloon, DCB, OCT