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Updated: Jul 14, 2026

Imaging In-Stent Restenosis: An Inexpensive, Reliable, and Rapid Preclinical Model
Published on: September 14, 2009
Intravascular Lithotripsy Treatment With In-Stent Underexpansion Followed by Angiography, Optical Coherence
Kazuki Matsuda1, Tetsumin Lee1, Takashi Ashikaga1
1Department of Cardiology, Japanese Red Cross Musashino Hospital, Tokyo, Japan.
Background:
There are no reports in which in-stent restenosis (ISR) lesion treated by intravascular lithotripsy (IVL) is followed by coronary angioscopy examination in addition to coronary angiography and optical coherence tomography.
Case Summary:
A 53-year-old man with stable angina underwent drug-eluting stent implantation in the left anterior descending artery lesion with severe calcification 4 years before and an underexpansion remained. Despite high-pressure balloon dilatations with multiple sessions, adequate lumen area could not be obtained. However, we performed revascularization with IVL and excellent stent expansion was achieved. Seven months later, follow-up coronary angiography with optical coherence tomography and coronary angioscopy revealed sustained acute lumen gain with no evidence of stent recoil or ISR.
Discussion:
ISR lesion was successfully treated with IVL and assessed by multimodality imaging.
Take-Home Message:
This case highlights the potential efficacy of IVL for underexpanded ISR lesions with severe calcification.
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