Surgical management of multiple in-stent restenosis with coronary endarterectomy and stentectomy

In-stent restenosis remain the most important problem of coronary stent implantation. The number of patients with in-stent restenosis of coronary arteries is increasing in the practice of heart surgeons. We report a successful treatment of a patient with multiple in-stent restenosis of coronary arteries. LAD was treated with long arteriotomy of about 8 sm followed by open coronary endarteriectomy and stentectomy. The arteriotomy was then reconstructed with a venous patch and distal anastomosis with the LIMA then performed. The patient’s postoperative period was uncomplicated. At a 6-month follow- up examination, the patient is doing well and is asymptomatic. Combined open endarterectomy and stentectomy appears to be an effective alternative surgical treatment of FMJ-LAD and multiple intra-stent restenoses and gives a chance of full revascularization for such patients.