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Restenosis of a drug eluting stent on the previous bioresorbable vascular scaffold successfully treated with a drug-coated balloon: A case reportopen access

Authors
Jang, Hyun GyungKim, KyehwanPark, Hyun WoongKoh, Jin-SinJeong, Young-HoonPark, Jeong RangKang, Min Gyu
Issue Date
26-Jan-2021
Publisher
BAISHIDENG PUBLISHING GROUP INC
Keywords
Bioresorbable vascular scaffold thrombosis; In-stent restenosis; Drug-coated balloon; Optical coherence tomography; Intensive dual antiplatelet therapy; Case report
Citation
WORLD JOURNAL OF CLINICAL CASES, v.9, no.3, pp 758 - 763
Pages
6
Indexed
SCIE
SCOPUS
Journal Title
WORLD JOURNAL OF CLINICAL CASES
Volume
9
Number
3
Start Page
758
End Page
763
URI
https://scholarworks.gnu.ac.kr/handle/sw.gnu/4214
DOI
10.12998/wjcc.v9.i3.758
ISSN
2307-8960
Abstract
BACKGROUND The in-stent restenosis (ISR) rates are reportedly inconsistent despite the increased use of second-generation drug eluting stent (DES). Although bioresorbable vascular scaffold (BVS) have substantial advantages with respect to vascular restoration, the rate of scaffold thrombosis is higher with BVS than with DES. Optimal treatment strategies have not been established for DES-ISR to date. CASE SUMMARY We report on a case of a 60-year-old man patient with acute coronary syndrome. He had a history of ST-segment elevation myocardial infarction associated with very late scaffold thrombosis and treated with a DES. Coronary angiography revealed significant stenosis, suggesting DES-ISR on the previous BVS. Optical coherence tomography (OCT) identified a plaque rupture and a disrupted scaffold strut in the neointimal proliferation of DES. To treat the DES-ISR on the previous BVS, we opted for a drug-coated balloon (DCB) after a balloon angioplasty using a semi-compliant and non-compliant balloon. The patient did not experience adverse cardiovascular events on using a DCB following the use of intensive dual antiplatelet therapy and statin for 24 mo. CONCLUSION This case highlights the importance of OCT as an imaging modality for characterizing the mechanism of target lesion failure. The use of a DCB following the administration of optimal pharmacologic therapy may be an optimal strategy for the treatment and prevention of recurrent BVS thrombosis and DES-ISR.
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