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The drug-coated balloon (DCB) is a device that is used to reduce the risk of stent re-implantation in patients with in-stent restenosis (ISR). However, imaging findings of the drug covering the neointimal plaque immediately after treatment of ISR by DCB, and during follow-up, have only been discussed in a few reports. Herein, we describe the use of optical coherence tomography (OCT) and angioscopy to evaluate ISR before and after treatment with DCB, and during the follow-up period in 3 patients. The patients developed critical ISR during the follow-up period after drug-eluting stent (DES) implantation. The patients included a 70-year-old woman, a 70-year-old man, and an 80-year-old man. These imaging modalities provided data about the various etiologies of ISR, and about the efficacy of DCB angioplasty. Based on the findings of the intracoronary images in these 3 cases, we concluded that DCB might not only inhibit neointimal proliferation, but also reduce neointimal volume and lead to changes in in-stent neointimal morphology.

Serial Observations of In-Stent Restenosis Treated With Drug-Coated Balloon Angioplasty by Optical Coherence Tomography and Coronary Angioscopy