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

Video Transcription

Video Summary

The discussion detailed the complexities of treating instant restenosis, particularly when it involves bifurcations, and the recalcitrant nature of such cases. A panel of experts, including pioneers like Ron Waksman, shared insights and specific case studies. One such case involved an 80-year-old male with a history of CAD and previous PCI, now presenting severe instant restenosis in the LAD. The outlined approach emphasized the importance of imaging for precise diagnosis and treatment. Various techniques were explored for plaque modification, such as the use of IVL, Rotablator, and importantly, drug-coated balloons (DCB) to minimize tissue recoil and reduce long-term restenosis risks. The experts debated the efficacy of different methodologies like laser and cutting balloons, focusing on achieving durable treatment outcomes. Additionally, the conversation underscored the potential high cost and the challenge of treating intricate lesions, advocating for a tailored approach based on specific lesion characteristics and imaging findings.

Keywords

instant restenosis

bifurcations

plaque modification

drug-coated balloons

imaging diagnosis

treatment techniques