Abstract
A 58-year-old man with hypertension and dyslipidaemia was hospitalized for angina pectoris. He underwent directional coronary atherectomy (DCA) followed by dilatation with a 3.5 × 15 mm paclitaxel-coated balloon (PCB) for severe stenosis in the proximal segment of the left anterior descending coronary artery (LAD) (Panels A–C). Intravascular ultrasound (IVUS) demonstrated a large, layered, and mostly highly echoic plaque (Panel E). The lesion was successfully resected (Panels B and F), and sufficient coronary blood flow was achieved (Panels C and G). Histopathological analysis of the retrieved DCA specimen showed smooth muscle cell (SMC)-rich fibrous plaque (α-smooth muscle actin) without macrophages (CD68) (Panels I1–4). The patient was re-admitted 6 months later for chest pain. Coronary angiography identified restenosis in the proximal LAD (Panel D). We decided to repeat DCA and then implant a drug-eluting stent. IVUS of the restenotic lesion showed a plaque with iso and high echogenicity (Panel H). Histopathological analysis of the DCA specimens revealed the proliferation of numerous stellate cells and a proteoglycan-rich matrix. Immunostaining also demonstrated that these cells were mostly SMCs, with very few macrophages (Panels J1–4).
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
