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Updated: Mar 5, 2026

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
A case of severely calcified neoatherosclerosis after paclitaxel eluting stent implantation
Kei Yamamoto1, Kenichi Sakakura1, Yousuke Taniguchi1
1Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
Insights
This study details a case of calcified neoatherosclerosis in a paclitaxel-eluting stent (PES), a rare complication. Advanced imaging techniques like optical frequency domain imaging (OFDI) and intravascular ultrasound (IVUS) were crucial for diagnosis and treatment.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Biomedical Imaging
Background:
- In-stent restenosis (ISR) is a significant complication after percutaneous coronary intervention (PCI).
- Neoatherosclerosis, characterized by lipid-rich macrophages and calcification, is an underdiagnosed cause of ISR, particularly after drug-eluting stent (DES) implantation.
- Distinguishing between different types of ISR is critical for effective treatment strategies.
Abstract:
A 79-year-old male who had a history of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) received coronary angiography (CAG), because of angina pectoris. CAG showed in-stent restenosis of the paclitaxel-eluting stent (PES). Since the devices could not pass the lesion, we performed rotational atherectomy. Although we could not identify the calcified lesion by the optical frequency domain imaging (OFDI) findings because of strong attenuation, the intravascular ultrasound (IVUS) image showed the superficial calcification. On the other hand, strong attenuation in OFDI suggested the presence of foamy macrophage, which was essential for the diagnosis of neoatherosclerosis. We could obtain a favorable result by deploying another drug-eluting stent. While an earlier report showed the calcified neoatherosclerosis following bare-metal stent implantation, we clearly showed the calcified neoatherosclerosis following PES implantation.
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