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Optical coherence tomography (OCT) is a recently developed optical imaging technique that provides high‐resolution (approximately 10–20 μm) cross‐sectional images of vessels.
A 74‐year‐old man was admitted for chest pain. A coronary angiogram showed diffuse in‐stent restenosis of an Express (Boston Scientific Corporation and Medinol Ltd) 2.75 × 15 mm stent which had been implanted in the left anterior descending coronary artery six months earlier (panel A; arrow). Using OCT (Image Wire, LightLab Imaging, Inc) imaging, well‐apposed stent struts and neointima formation around the stent were clearly visualised (panel B). We performed angioplasty by using Cutting Balloon Ultra (Boston Scientific Corporation and Medinol Ltd) for this lesion. After the cutting balloon procedure, a coronary angiogram showed a very smooth lumen border (panel C; arrow). However, OCT imaging showed that the lumen surface was irregular with fissures of neointima formation. OCT imaging may be useful in assessing small structural details of the coronary artery, such as neointima formation after stent implantation and the presence of fissures after angioplasty.angioplasty.