Coronary August 2020

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The Mount Sinai Hospital

1468 Madison Avenue, New York,
New York 10029

Stent Ablation with RA of Underexpanded Multilayer DES

In-stent restenosis

63 year-old male with known CAD, CABG x2 (1999) and multiple PCI’s to SVG to RCA and LCx branches presented with CCS Class IV angina and non-STEMI (TnI 1.2U). A Cardiac Cath on June 22, 2020 revealed patent LIMA to LAD, non obstructive LCx branches with patent prior stents and 90% multilayer in-stent restenosis of SVG to distal RCA (underexpanded stent) and LVEF 60%. Patient underwent partially successful intervention of SVG to distal RCA lesion using PTCA and atherotomy with residual 50% stenosis due to underexpanded stent. Patient is now planned for OCT guided PCI of multilayer underexpanded stent restenosis of SVG to distal RCA using rotational atherectomy (stent ablation with RA).


Case Presentation


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