ABSTRACT
The size of a diffusely diseased left main stem is angiographically difficult to determine, and in these cases in particular one must not undersize balloons or stents.
In-stent restenosis may not always be due to neointimal hyperplasia but may also be caused by initially unrecognized local stent underexpansion, which may occur in particular with the use of less radiopaque stents. Pre-examination with IVUS of the in-stent restenotic segment may lead to the correct diagnosis, which allows proper balloon expansion of this stent. An initially unrecognized malapposition of the stent may be the cause of later intracoronary thrombotic complications (Figure 14.21).
