Rotational Atherectomy of In-Stent Restenosis

A 75-year-old patient with multiple previous PCIs including 2 second generation DES to the RCA, presented for elective PCI for the recurrent ISR. Coronary angiogram showed a 70-80% stenosis in both proximal and mid segment of the RCA; underexpansion of the stent implanted into the mid RCA was suspected based on angiography.