Strategies in Bifurcation In-Stent Restenosis (ISR)-Dr. Croce case presentation

Video Transcription

Video Summary

An 84-year-old woman with severe coronary artery disease underwent a challenging procedural intervention due to her frailty and complex lesions, including severe calcifications. Initially, a coronary intervention with stenting was performed, but she returned 11 months later with stent failure due to calcific nodules, stent fractures, and in-stent restenosis. The treatment involved intravascular lithotripsy (IVL) and re-stenting, despite hesitations about added complexity. The team also considered aggressive pharmacotherapy and potential use of brachytherapy to manage recurrent restenosis, highlighting the difficulties in treating calcific nodular disease and stent failure effectively.

Keywords

coronary artery disease

intravascular lithotripsy

stent failure

calcific nodules

recurrent restenosis