Treatment of In-Stent Restenosis by Excimer Laser Coronary Atherectomy and Drug-Coated Balloon: Serial Assessment with Optical Coherence Tomography
Figure 4
Representative angiographic and FD-OCT images: dissection and healing. The angiographic and FD-OCT images are shown before, after the PCI procedure, and at 6 months of follow-up in the ELCA group (a–h). (a) Baseline angiogram showing BMS ISR in the LAD (white dotted line). (b) 1.4-mm ELCA with saline flush at 60 mJ/40 Hz. (c) Final angiogram after DCB dilatation (SeQuent Please 3.5/26 mm inflated at 8 atm for 45 seconds). (d) Six-month follow-up angiogram. (e) Pre-PCI FD-OCT image. (f) Cavities after ELCA (yellow arrow). (g) Flap dissections after PCI (yellow arrow). (h) Completely healed with restoration of smooth luminal contour at 6 months of follow-up. FD-OCT, frequency-domain optical coherence tomography; PCI, percutaneous coronary intervention; ELCA, excimer laser coronary atherectomy; BMS, bare-metal stent; ISR, in-stent restenosis; LAD, left anterior descending artery; DCB, drug-coated balloon; PCI, percutaneous coronary intervention.