A severely calcified neointima 9 years after bare metal stent implantation.

An increasing number of studies have reported intimal atherosclerotic changes, or neoatherosclerosis in the late phase after bare metal stent implantation, however, only a few reports have showed the presence of severe intimal calcification in a bare metal stent. We herein report a case of a 68-year-old male with severely calcified neointima occurring 9 years after the bare metal stent implantation. Pre-procedural coronary computed tomography angiography and peri-procedural intravascular ultrasound demonstrated severe calcification within the in-stent restenotic lesion. Although the pre-dilation balloon ruptured due to the calcification, the lesion was nevertheless successfully dilated with the stent. Calcified lesions often require complex techniques, and we therefore should be aware of the potential occurrence of a severely calcified neointima in coronary stents, and performing coronary computed tomography angiography in advance is a great help for performing effective coronary intervention.