Related Experiment Video
Updated: Aug 5, 2026
Imaging In-Stent Restenosis: An Inexpensive, Reliable, and Rapid Preclinical Model
Published on: September 14, 2009
Succesful antegrade subintimal bypass restenting of in-stent chronic total occlusion
Henry C Quevedo1, Anand Irimpen1, Nidal Abi Rafeh1
1Division of Cardiology, Tulane University Heart and Vascular Institute, New Orleans, Louisiana.
Insights
Treating coronary chronic total occlusions (CTOs) within stents is challenging. A novel controlled subintimal dissection re-entry technique successfully bypassed a right coronary artery CTO, creating side-by-side stents.
Area of Science:
- Interventional cardiology
- Vascular interventions
- Cardiovascular disease management
Background:
- Coronary chronic total occlusions (CTOs) significantly increase patient morbidity.
- Advanced techniques and devices have improved CTO treatment.
- Managing CTOs within previously placed coronary stents presents unique challenges.
Observation:
- A case involving in-stent restenosis of a right coronary artery CTO is presented.
- The CTO was located within a previously placed coronary stent.
Findings:
- A controlled subintimal dissection re-entry technique was employed.
- The antegrade approach facilitated the procedure.
- Successful bypass of the CTO was achieved, creating side-by-side stents.
Implications:
- This technique offers a potential solution for complex in-stent CTOs.
- It may improve outcomes for patients with challenging coronary artery disease.
- Further research can explore the broader applicability of this approach.
Abstract:
Coronary chronic total occlusions (CTOs) are known to cause significant patient morbidity. Over the past several years, the techniques and devices for treating these CTOs have advanced tremendously. The interventional management of CTOs within previously placed coronary stents, however, remains challenging. Here, we present a case of an in-stent restenosis of the right coronary artery CTO bypassed using a controlled subintimal dissection re-entry technique via antegrade approach creating side-by-side stents.
