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Excimer Laser-Assisted Angioplasty for In-Stent Restenosis of the Right Coronary Artery in a Diabetic Patient: A

Vasavdatta Sharma1, Tom Devasia1, Monika Jawanjal1

  • 1Department of Cardiology Kasturba Medical College, Manipal India.

Clinical Case Reports
|September 24, 2025
PubMed

Insights

This case study highlights excimer laser use for complex in-stent restenosis (ISR) in a diabetic patient with coronary artery disease. Advanced techniques like laser-assisted percutaneous coronary intervention (PCI) enabled successful treatment.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Devices

Background:

  • In-stent restenosis (ISR) remains a challenge after percutaneous coronary interventions (PCIs).
  • Heavily calcific lesions complicate revascularization strategies.
  • Diabetic patients often present with complex coronary artery disease.

Purpose of the Study:

  • To present a case of successful laser-assisted PCI for complex ISR.
  • To demonstrate the utility of excimer laser in managing challenging restenotic lesions.
  • To emphasize tailored treatment approaches for ISR.

Main Methods:

  • Coronary angiography to diagnose ISR.
  • Excimer laser atherectomy for lesion preparation.
  • Drug-eluting stent (DES) implantation.
  • Intravascular ultrasound (IVUS) guidance for optimal stent deployment.

Main Results:

  • Successful revascularization of the right coronary artery (RCA) ISR.
  • Resolution of exertional angina symptoms.
  • Demonstrated feasibility of laser use in complex calcific ISR.

Conclusions:

  • Excimer laser is a valuable tool for treating complex ISR.
  • IVUS guidance enhances procedural success in challenging PCI cases.
  • Individualized treatment strategies are crucial for managing ISR in diabetic patients.

Keywords:
IVUSchronic total occlusiondiabetes mellitusexcimer laser angioplastyin‐stent restenosispercutaneous coronary interventionright coronary artery

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