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In-stent neoatherosclerosis 10 years after bare metal stent implantation: ruptured vulnerable plaque by optical coherence tomography

EuroIntervention 2014;10:494 published online ahead of print November 2013. DOI: 10.4244/EIJV10I4A83

Department of Interventional Cardiology, Hospital Israelita Albert Einstein, São Paulo, Brazil
In-stent neoatherosclerosis has recently been described as an important mechanism of late stent failure. A 56-year-old man with a single bare metal stent implantation ten years previously presented with new-onset chest pain. Coronary angiography revealed a right coronary artery with focal in-stent restenosis (Online Figure 1). Optical coherence tomography (OCT) demonstrated the presence of fibroatheroma throughout the entire length of the stent. At one point (panel C), a thin-cap fibroatheroma (TCFA) with plaque rupture is noted (Figure 1, Online Figure 2).

Figure 1. The OCT images from distal (A) to proximal (H). Arrowheads indicate stent struts. A lipid-rich (asterisk) plaque with a ...

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