Ruptured-plaque-like appearance of restenotic tissue following sirolimus-eluting stent implantation: an optical coherence tomography case study.

A 57-year-old man was admitted for exertional angina pectoris. Coronary angiography showed a 99% stenosis in the left circumflex artery. A sirolimus-eluting stent was deployed in the culprit lesion and excellent angiographic results were obtained. Six-month routine follow-up coronary angiography showed a 90% focal restenosis at the proximal edge of the stent. At this site, optical coherence tomography imaging revealed restenotic tissue with a ruptured-plaque-like appearance overlying the stent struts. Also, a low intensity area suggestive of the presence of a lipid core was evident within the neointimal tissue in another cross section.