In-stent restenosis (ISR) of Right Coronary Artery (RCA)

Patient History

  • ISR in the RCA
  • FFR: 0.78
  • Inferior ischemia on Cardiolite®1

Baseline Angiography

Baseline angiography of RCA

Baseline HD IVUS

Baseline HD IVUS of proximal and mid-RCA lesions

Pre-PCI HD IVUS (1)

  • Following baseline HD IVUS guidance, a 1st pre-PCI balloon dilation is performed using 3.5 mm X 6.0 mm cutting balloon at 12 ATM.
  • This is followed by 2nd pre-PCI balloon dilation using 4.0 mm × 12.00 mm NC Emerge™ PTCA Dilation Catheter2 at 28 ATM.
  • HD IVUS measurements of proximal and mid-lesion are taken after 1st and 2nd pre-PCI balloon dilations.

Pre-PCI Angiography

A laser atherectomy is used followed by 4.0 mm x 12.0 mm NC Emerge™ PTCA Dilation Catheter2.

Pre-PCI HD IVUS (2)

HD IVUS after laser atherectomy and 4.0 mm x 12.0 mm NC Emerge™ PTCA Dilation Catheter2 dilation.

Post-PCI Angiography

RCA is stented using 3.5 mm X 28.0 mm Promus PREMIER™ Everolimus-Eluting Platinum Chromium Coronary Stent3. This is followed by post-stent dilation using a 4.0 mm X 12.0 mm NC Emerge™ PTCA Dilation Catheter2.

Post-PCI HD IVUS

Post-PCI HD IVUS

Conclusion

HD IVUS reveals the ISR within the RCA, helped with sizing of RCA, revealed the success of balloon dilations, atherectomy, facilitating an optimal PCI result.

References

  1. Cardiolite® is a trademark of Lantheus Medical Imaging
  2. NC Emerge is a trademark of Boston Scientific Corp.
  3. Promus PREMIER™ is a trademark of Boston Scientific Corp.

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