Unusual Response of Subclavian In-Stent Restenosis to Balloon Angioplasty in a Patient with HIV

Area of Science:

• Cardiovascular Medicine
• Infectious Diseases
• Vascular Surgery

Background:

• Human Immunodeficiency Virus (HIV) infection and protease inhibitor (PI) therapy are linked to accelerated atherosclerosis.
• Coronary in-stent restenosis rates are elevated in HIV-infected patients.
• Data on peripheral vascular disease interventions in this population is scarce.

Purpose of the Study:

• To report a rare case of aggressive subclavian in-stent restenosis in an HIV-infected patient.
• To describe an unusual response to balloon angioplasty, including tissue flap formation.
• To detail the subsequent management of this complex peripheral vascular event.

Main Methods:

• Case report of a patient with HIV infection and subclavian in-stent restenosis.
• Intervention involved balloon angioplasty.
• Management of complications included repeat stenting.

Main Results:

• An aggressive subclavian in-stent restenosis was observed.
• Balloon angioplasty led to unexpected large, mobile tissue flap formation.
• Successful treatment was achieved with a subsequent stent placement.

Conclusions:

• Peripheral vascular interventions in HIV patients require careful consideration due to potential accelerated atherosclerosis.
• Unusual complications like large tissue flaps can occur during angioplasty.
• Aggressive management with repeat stenting may be necessary for complex restenosis in this cohort.