Cardiovascular Journal of Africa: Vol 28 No 6 (November/December 2017)

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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 28, No 6, November/December 2017 404 AFRICA
Images in Cardiology
Unusually aggressive immature neo-intimal hyperplasia
causing in-stent restenosis
Keir McCutcheon, Andreas S Triantafyllis, Johan Bennett, Tom Adriaenssens
Abstract
This image illustrates a very unusual pattern of early and
aggressive immature neo-intimal hyperplasia in a 52-year-old
man with unstable angina, two months after deployment of
a drug-eluting stent in the proximal left anterior descending
artery.
C
F E D *
C
D E F
Fig. 1. A: Still frame of left coronary angiography showing restenosis in the proximal LAD. Letters in black correspond with the optical
coherence tomography (OCT) images that follow. B–F: OCT from distal to proximal left anterior descending (LAD) and left main-
stem demonstrating mature neo-intimal hyperplasia in mid-LAD stent (C, asterisk), aggressive immature neo-intimal hyperplasia
in the proximal LAD stent (D, double arrowhead line) with tissue protrusion (E, arrowheads) and stent edge vascular response (F).
A
B
C
E
D
F
Department of Cardiovascular Medicine, University
Hospitals Leuven, Leuven, Belgium
Keir McCutcheon, BSc (Hons), MSc, MB BCh, FCP (SA), Cert
Cardiol (SA),
Andreas S Triantafyllis, MD, PhD
Johan Bennett MB BCh, MD
Tom Adriaenssens, MD, PhD