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 1^st pre-PCI balloon dilation is performed using 3.5 mm X 6.0 mm cutting balloon at 12 ATM.
• This is followed by 2^nd 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 1^st and 2^nd 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.