DOI:

Paclitaxel-eluting stent restenosis shows three-layer appearance by optical coherence tomography

Shuzou Tanimoto, MD; Jiro Aoki, MD; Patrick W. Serruys, MD, PhD; Evelyn Regar*, MD, PhD

A 73-year-old woman with hypertension, hyperlipidemia and positive familial history of coronary artery disease presented with Canadian Cardiovascular Society class III angina and underwent coronary angiography, which showed a chronic occluded right coronary artery (Panel A). The vessel was recanalized and treated with three paclitaxel-eluting stents (TAXUS®, Boston Scientific: 3.5 x 32 mm distally, 3.5 x 28 mm in the middle part, 3.5 x 12 mm proximally). Postintervention coronary angiography showed a good result (Panel B). Twelve-month follow-up angiography revealed focal in-stent restenosis (Panel C). Intracoronary optical coherence tomography (OCT: LightLabImaging™, Boston, MA, USA) pullback displayed well-expanded stents covered with a thin, homogenous, highly reflective neointimal layer (Panel D, E). In contrast, the narrowest lesion site (minimal lumen area 1.1 mm2; stent area 9.0 mm2) showed a three-layer appearance of the neointima (Panel F). The inner luminal layer appeared concentric, homogenous and signal-rich (maximal thickness 0.27 mm). A second layer consisting of a low-reflective area with poorly delineated borders followed. The third layer was in direct contact with the stent struts and revealed only minimal signal intensity. These signal-poor areas (maximal thickness 1.18 mm) might represent acellular fibrinoid deposition that has been well described in experimental studies. The patient was re-treated with repeat paclitaxel-eluting stent implantation.

OCT is an analogue of intravascular ultrasound with an ultra-high resolution (10 µm) superior to any current available imaging modalities. This imaging device may be useful in visualizing neointimal growth in drug-eluting stents and improve our understanding of its underlying physiopathology in the future.

Volume 1 Number 4
Feb 20, 2006
Volume 1 Number 4
View full issue


Key metrics

Suggested by Cory

Research Correspondence

10.4244/EIJ-D-25-00068 Jul 21, 2025
Intracoronary nicardipine to induce hyperaemia
Viscusi M et al

Editorial

10.4244/EIJ-E-25-00023 Jul 21, 2025
DAPT de-escalation post-ACS: a new rule or just a new option? Lessons from the 4D-ACS trial
Cuisset T and Cayla G
free

Viewpoint

10.4244/EIJ-D-24-00943 Jul 21, 2025
Factor XI inhibition for ACS patients: premises and prospects
Lopes R and Fanaroff A
free

State-of-the-Art

10.4244/EIJ-D-24-00387 Jul 21, 2025
Advances in coronary imaging of atherosclerotic plaques
Garcia-Garcia H et al
free

Research Correspondence

10.4244/EIJ-D-25-00025 Jul 21, 2025
Validation of the pullback pressure gradient in resting conditions
Sakai K et al

Editorial

10.4244/EIJ-E-25-00031 Jul 21, 2025
Supersaturated oxygen therapy to reduce myocardial infarct size: time to pay attention!
Stone G and Akinmolayemi O
free
Trending articles
224.5

State-of-the-Art Review

10.4244/EIJ-D-21-00426 Dec 3, 2021
Myocardial infarction with non-obstructive coronary artery disease
Lindahl B et al
free
172.65

Focus article

10.4244/EIJY19M08_01 Jan 17, 2020
EHRA/EAPCI expert consensus statement on catheter-based left atrial appendage occlusion – an update
Glikson M et al
free
80.3

State-of-the-Art

10.4244/EIJ-D-24-00066 Apr 21, 2025
Management of complications after valvular interventions
Bansal A et al
free
47.75

Original Research

10.4244/EIJ-D-25-00331 May 21, 2025
One-month dual antiplatelet therapy followed by prasugrel monotherapy at a reduced dose: the 4D-ACS randomised trial
Jang Y et al
open access
47.75

Original Research

10.4244/EIJ-D-25-00331 Jul 21, 2025
One-month dual antiplatelet therapy followed by prasugrel monotherapy at a reduced dose: the 4D-ACS randomised trial
Jang Y et al
open access
23.7

Expert review

10.4244/EIJ-D-18-01180 Feb 20, 2020
Technical aspects in coronary sinus Reducer implantation
Giannini F et al
free
X

PCR
Impact factor: 9.5
2024 Journal Citation Reports®
Science Edition (Clarivate Analytics, 2025)
Online ISSN 1969-6213 - Print ISSN 1774-024X
© 2005-2025 Europa Group - All rights reserved