Top

Cardiovascular Intervention and Therapeutics

Published in:

01-01-2016 | Case Report

Successful rotational atherectomy for a repetitive restenosis lesion with underexpansion of double layer drug-eluting stents due to heavily calcified plaque

Authors: Masahito Kawata, Yukinori Kato, Hiroki Takada, Kohei Kamemura, Akira Matsuura, Susumu Sakamoto

Published in: Cardiovascular Intervention and Therapeutics | Issue 1/2016

Abstract

A 72-year-old male was treated. First percutaneous coronary intervention (PCI) for chronic total occlusion of proximal left anterior descending artery was performed after rotational atherectomy with 1.5-mm burr. Focal underexpansion of Promus stent occurred due to the heavily calcified plaque. After first restenosis, OCT-guided PCI was performed with 26 atm balloon dilatation. After second restenosis, Resolute Integrity was implanted. After third restenosis, rotational atherectomy with 1.5-, 1.75- and 2.15-mm burrs was performed. All stent struts disappeared at the lesion and Promus Element was implanted. No restenosis occurred after 6 months. Cautious rotational atherectomy could ablate double layer drug-eluting stents effectively.

Holmes DR, Shaughnessy CO, Caputo RP, Kereiakes DJ, Williams DO, Teirstein PS, et al. Sirolimus-eluting stents versus standard stents in patients with stenosis in a native coronary artery. New Engl J Med. 2003;349:1315–23.PubMedCrossRef

Mintz GS, Hoffmann R, Mehran R, Pichard AD, Kent KM, Satler LF, et al. In-stent restenosis: the Washington Hospital Center experience. Am J Cardiol. 1998;81(7A):7E–13E.PubMedCrossRef

Mintz GS, Potkin BN, Keren G, Satler LF, Pichard AD, Kent KM, et al. Intravascular ultrasound evaluation of the effect of rotational atherectomy in obstructive atherosclerotic coronary artery disease. Circulation. 1992;86(5):1383–93.PubMedCrossRef

Mintz GS, Popma JJ, Hong MK, Pichard AD, Kent KM, Satler LF, et al. Intravascular ultrasound to discern device-specific effects and mechanisms of restenosis. Am J Cardiol. 1996;78(3A):18–22.PubMedCrossRef

Albrecht D, Kaspers S, Füssl R, Höpp HW, Sechtem U. Coronary plaque morphology affects stent deployment: assessment by intracoronary ultrasound. Cathet Cardiovasc Diagn. 1996;38(3):229–35.PubMedCrossRef

Hoffmann R, Mintz GS, Popma JJ, Satler LF, Kent KM, Pichard AD, et al. Treatment of calcified coronary lesions with Palmaz-Schatz stents. An intravascular ultrasound study. Eur Heart J. 1998;19(8):1224–31.PubMedCrossRef

Kobayashi Y, Teirstein PS, Linnemeier TJ, Stone GW, Leon MB, Moses JW. Rotational atherectomy (stentablation) in a lesion with stent underexpansion due to heavily calcified plaque. Cathet Cardiovasc Interv. 2001;52:208–11.CrossRef

Sunew J, Chandwaney RH, Stein DW, Meyers S, Davidson CJ. Excimer laser facilitated percutaneous coronary intervention of a nondilatable coronary stent. Cathet Cardiovasc Interv. 2001;53:513–7.CrossRef

Mehran R, Dangas G, Mintz GS, Waksman R, Abizaid A, Satler LF, et al. Treatment of in-stent restenosis with excimer laser coronary angioplasty versus rotational atherectomy: comparative mechanisms and results. Circulation. 2000;101:2484–9.PubMedCrossRef

10.

Egred M. A novel approach for under-expanded stent: excimer laser in contrast medium. J Invasive Cardiol. 2012;24(8):E161–3.PubMed

11.

Sharma SK, Duvvuri S, Dangas G, Kini A, Vidhun R, Venu K, et al. Rotational atherectomy for in-stent restenosis: acute and long-term results of the first 100 cases. J Am Coll Cardiol. 1998;32(5):1358–65.PubMedCrossRef

12.

Yamashita K, Ochiai M, Yakushiji T, Ebara S, Okabe T, Yamamoto MH, et al. Repeat drug-eluting stent implantation for in-stent restenosis: first- or second-generation stent. J Invasive Cardiol. 2012;24(11):574–8.PubMed

13.

Faramarzi N, Salarifar M, Kassaian SE, Zeinali AMH, Alidoosti M, Pourhoseini H, et al. Mid-term follow-up of drug-eluting stenting for in-stent restenosis: bare-metal stents versus drug-eluting stents. J Tehran Heart Cent. 2013;8(1):14–20.PubMedPubMedCentral

14.

Colombo A, Chieffo A, Frasheri A, Garbo R, Masotti M, Salvatella NO, Dominguez JF, Steffanon L, Tarantini G, Presbitero P, Menozzi A, Pucci EM. J, Cesana BM, Giustino G SG. Second generation drug-eluting stents implantation followed by six versus twelve-month—dual antiplatelet therapy—the SECURITY randomized clinical trial. J Am Coll Cardiol. 2014;S0735–1097(14):06155–6.

15.

El-Hayek G, Messerli F, Bangalore S. Hong MK, Herzog E B, A T-HJ. Meta-analysis of randomized clinical trials comparing short-term versus long-term dual antiplatelet therapy following drug-eluting stents. Am J Cardiol. 2014;114:236–42.PubMedCrossRef

Title: Successful rotational atherectomy for a repetitive restenosis lesion with underexpansion of double layer drug-eluting stents due to heavily calcified plaque
Authors: Masahito Kawata
Yukinori Kato
Hiroki Takada
Kohei Kamemura
Akira Matsuura
Susumu Sakamoto
Publication date: 01-01-2016
Publisher: Springer Japan
Published in: Cardiovascular Intervention and Therapeutics / Issue 1/2016
Print ISSN: 1868-4300
Electronic ISSN: 1868-4297
DOI: https://doi.org/10.1007/s12928-015-0319-3

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The STEP trials

Springer Medicine

Successful rotational atherectomy for a repetitive restenosis lesion with underexpansion of double layer drug-eluting stents due to heavily calcified plaque

Abstract

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2016

Safety and feasibility of the new 5 Fr Glidesheath Slender

Stent dislodgement induced by a vasodilator used for severe coronary artery spasm caused by Kounis syndrome

Coronary thrombus aspiration revealed tumorous embolism of myxofibrosarcoma from the left atrium

Tissue characteristics of non-culprit plaque in patients with acute coronary syndrome vs. stable angina: a color-coded intravascular ultrasound study

Comparison of Everolimus- versus Sirolimus-eluting stents in the provisional Bifurcation stenting guided by intravascular ultrasound: mid-term results of the J-REVERSE registry

Transcatheter aortic valve implantation and simultaneous closure of associated paravalvular leak

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page