Embolization of Neoatherosclerosis After Percutaneous Coronary Intervention
Insights From Near-Infrared Spectroscopy Imaging and Histopathological Analysis

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Introduction
An 85-year-old man was hospitalized because of ST-segment–elevation myocardial infarction 145 months after the implantation of sirolimus-eluting Cypher stent. Emergent coronary angiography identified in-stent restenosis at the body of sirolimus-eluting Cypher stent in the proximal right coronary artery (Figure [A]). Optical coherence tomography visualized rupture of lipidic neointima potentially containing cholesterol crystals (Figure [B]). Near-infrared spectroscopy (NIRS) combined with intravascular ultrasound showed extensive yellow signals indicating lipid accumulation, potentially both within and outside the stent, with a high, maximum 4-mm lipid core burden index with 880 (Figure [C] and [D]). After an implantation of cobalt–chromium everolimus-eluting stent, no-reflow phenomenon with thrombolysis in …
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- Embolization of Neoatherosclerosis After Percutaneous Coronary InterventionKensaku Nishihira, Fumiyuki Otsuka, Yu Kataoka, Yasuhide Asaumi, Kohei Kaneta, Hiroki Nakano, Keiko Ohta-Ogo, Hatsue Ishibashi-Ueda, Teruo Noguchi and Satoshi YasudaCirculation: Cardiovascular Interventions. 2018;11:e006175, originally published February 14, 2018https://doi.org/10.1161/CIRCINTERVENTIONS.117.006175
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- Embolization of Neoatherosclerosis After Percutaneous Coronary InterventionKensaku Nishihira, Fumiyuki Otsuka, Yu Kataoka, Yasuhide Asaumi, Kohei Kaneta, Hiroki Nakano, Keiko Ohta-Ogo, Hatsue Ishibashi-Ueda, Teruo Noguchi and Satoshi YasudaCirculation: Cardiovascular Interventions. 2018;11:e006175, originally published February 14, 2018https://doi.org/10.1161/CIRCINTERVENTIONS.117.006175