Coronary Intra-neointimal Hyperplasia Hematoma after High-Pressure Dilation.

A 68-year-old man was admitted for unstable angina pectoris. Six months previously, he was treated with two zotarolimus-eluting stents (ZESs) (2.75×24.0mm and 3.50×18.0mm) implanted from the proximal left anterior descending artery (LAD) to the left main artery (LM), and one ZES (2.50×18.0mm) in the proximal left circumflex coronary artery (LCX) (T-stenting strategy). Repeat coronary angiography showed in-stent restenosis (ISR) in the ostial LCX (Figure 1A) which was treated using a 2.50×26.0mm drug-coated balloon, and then kissing balloon inflations with a 3.50×15.0mm non-compliant balloon in the LAD and a 2.50×12.0mm non-compliant balloon in LCX, both at 6atm.