Angioscopic Evaluation of In-Stent Occlusion in the Superficial Femoral Artery Treated With Excimer Laser Atherectomy
Munehiro Iiya1, Yuko Onishi1, Ryota Arai1
1Department of Cardiology, Hiratsuka Kyosai Hospital, Hiratsuka, Japan.
Background:
In-stent occlusion (ISO) comprises various components, including thrombus and neointimal hyperplasia, but its detailed characteristics and treatment responses remain unclear.
Case Summary:
We performed excimer laser atherectomy (ELA) to treat an ISO in the superficial femoral artery. Multimodal imaging, including intravascular ultrasound, optical coherence tomography, and angioscopy, enabled detailed procedural assessment. Additionally, real-time angioscopy was performed from a contralateral approach during the ELA procedure to observe its effects dynamically. The results showed that although ELA had a limited effect on vaporizing the proximal cap and neointimal hyperplasia, it successfully dissipated thrombus and inflammatory tissue.
Discussion:
This is the first report to evaluate the effects of ELA on ISO lesions using multimodal imaging, including real-time angioscopy. This approach provides new insights into the potential benefits of ELA in endovascular therapy.
Take-Home Message:
ISO contains various components, including thrombus and neointimal hyperplasia. ELA demonstrated differential effects on each component.
