Volume 100, Issue 6 pp. 1036-1038
CASE REPORT

Lithotripsy for calcified in-stent restenosis. The “rock strata peeling pattern”: A novel fracture pattern detected by optical coherence tomography

David del Val MD

David del Val MD

Cardiology Department, Hospital Universitario de La Princesa, Madrid, Spain

Instituto de Investigación Sanitaria, Hospital Universitario de La Princesa (IIS-IP), CIBERCV, Madrid, Spain

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Javier Cuesta MD, PhD

Javier Cuesta MD, PhD

Cardiology Department, Hospital Universitario de La Princesa, Madrid, Spain

Instituto de Investigación Sanitaria, Hospital Universitario de La Princesa (IIS-IP), CIBERCV, Madrid, Spain

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Pilar Roquero MD

Pilar Roquero MD

Cardiology Department, Hospital Universitario de La Princesa, Madrid, Spain

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Fernando Alfonso MD, PhD

Corresponding Author

Fernando Alfonso MD, PhD

Cardiology Department, Hospital Universitario de La Princesa, Madrid, Spain

Instituto de Investigación Sanitaria, Hospital Universitario de La Princesa (IIS-IP), CIBERCV, Madrid, Spain

Correspondence Fernando Alfonso, MD, PhD, Cardiology Department, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria, IIS-IP, CIBER-CV, Universidad Autónoma de Madrid, c/Diego de León 62, 28006 Madrid, Spain.

Email: [email protected]

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First published: 13 October 2022

Abstract

Calcified neoatherosclerosis represents a particularly challenging scenario in patients with in-stent restenosis (ISR), frequently associated with worse angiographic and optical coherence tomography (OCT) results compared with other patients with typical ISR. Intravascular lithotripsy (IVL) has emerged as a safe and effective technology to circumferentially modify calcium in heavily calcified coronary lesions. Preliminary data also suggest its usefulness in calcified neoatheroscerosis. This case report aims to describe a novel fracture pattern after IVL identified by OCT (the “rock strata peeling pattern”) in patients presenting with ISR due to calcified neoatherosclerosis.

CONFLICT OF INTEREST

The authors declare no conflict of interest.

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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