Peri-Stent Abluminal Hematoma and Pin-Hole Balloon Rupture During Treatment of Calcified Drug-Eluting Stent In-Stent Restenosis

vascular ultrasound (IVUS) provided unique morphological insights and identification of the calcified underlying substrate of ISR. An 82-year-old man with a previous history of coronary gery and interventions on the circumflex coronary (LCX) was admitted for prolonged angina, transient electrocardiographic changes on lateral leads and troponin He had a previous history of cigarette smoking, hypertension, dyslipidemia, arly results of coronary interventions for patients with in-stent restenosis (ISR) are largely satisfactory. 1,2 In this setting lack of initial angiographic success or occurrence of procedural-related complications are exceedingly rare. 1,2 We report a patient presenting with old calcified ISR who experienced a pin-hole balloon rupture and peri-stent abluminal intramural hematoma during a repeated coronary intervention. Optical coherence tomography (OCT) and intra-E