Different patterns of in-stent coverage in drug-eluting stents.

A 65-year-old man had undergone percutaneous revascularization of the left anterior descending artery four years earlier, with two non-overlapping stents being implanted in the same procedure: a first-generation drug-eluting stent (DES) in the proximal segment (2.75 mm×16 mm TAXUS Element paclitaxel-eluting stent) and a second-generation DES in the mid segment (2.5 mm×24 mm PROMUS Element everolimus-eluting stent). The patient underwent new coronary angiography for effort angina, which demonstrated diffuse restenosis of the proximal stent, with a 71% obstructive lesion in the mid portion (Figure 1A). Optical coherence tomography demonstrated two different patterns of in-stent coverage in the two stents: mild proliferation of a homogeneous hyperintense neointima