Key result
OCT and histology link in-stent neoatherosclerosis to very late restenosis after CAS.
Why the study?
The role of in-stent neoatherosclerosis in the pathogenesis of very late stent restenosis after carotid artery stenting is not well understood.
Case Report (n=1)
No
In-stent neoatherosclerosis may play an important role in the pathogenesis of very late stent restenosis after carotid artery stenting.
Raises possibility of neoatherosclerosis in very late carotid ISR; hypothesis-generating and should not change practice.
We report a patient's case of slow progressive in-stent restenosis 10 years after bare-metal stent implantation to his carotid artery. We treated the patient with an additional stent placement under a distal filter protection device. Optical coherence tomographic assessment and plaque histology during the carotid artery stenting (CAS) revealed atheromatous change at in-stent neointima, which contained lipid-rich plaque and calcification deposits. These findings suggest that in-stent neoatherosclerosis may play an important role in the pathogenesis of very late stent restenosis after CAS.
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Matsumoto et al. (2013) conducted a case report in In-stent restenosis after carotid artery stent implantation (n=1). Additional stent placement under a distal filter protection device was evaluated on Optical coherence tomographic assessment and plaque histology findings. Optical coherence tomography and plaque histology revealed atheromatous change at in-stent neointima, suggesting neoatherosclerosis plays a role in very late stent restenosis after CAS.
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