Intimal hyperplasia by optical coherence tomography after BMS and DES implantation in the same artery

Drug eluting stents (DES) by inhibiting neointimal proliferation are associated with a much lower in-stent restenosis rate compared with bare metal stents (BMS). Studies supporting these data have included patients in whom either DES or BMS were implanted but not both. What has rarely been described is the vessel response against both types of stents in the same patient. This case illustrates the difference in neointimal hyperplasia after the deployment of a DES and a BMS in tandem lesions. Optical Coherence Tomography (OCT) at 5 years follow-up showed that neointimal proliferation had been inhibited almost entirely in the DES covered segment of the artery, in contrast to the BMS covered segment. Our images clearly demonstrated for the first time with OCT technology the different degree of neointimal proliferation between DES and BMS in the same artery.