Watanabe Ryuta, Kojima Keisuke, Yamashita Seigo, Ogawa Takayuki, Okumura Yasuo
Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
JACC Case Rep. 2025 Sep 3;30(26):104877. doi: 10.1016/j.jaccas.2025.104877.
A 33-year-old male developed pulmonary vein (PV) stenosis 3 months after PV isolation for atrial fibrillation. Stents were implanted in the left superior and inferior PVs, but 2 years later, in-stent restenosis occurred. Intravascular ultrasound and nonobstructive general angioscopy (NOGA) revealed severe ostial stenosis and neointimal hyperplasia. Drug-coated balloon angioplasty was performed, and NOGA confirmed paclitaxel deposition. This case highlights the utility of NOGA for directly visualizing neointimal changes and drug delivery, which are not assessable by intravascular ultrasound alone. This is the first report to demonstrate in-stent restenosis and post-drug-coated balloon changes in the pulmonary vein using NOGA.
一名33岁男性在因心房颤动进行肺静脉隔离术后3个月出现肺静脉（PV）狭窄。支架植入左肺上、下静脉，但2年后出现支架内再狭窄。血管内超声和非阻塞性普通血管内镜检查（NOGA）显示严重的开口处狭窄和新生内膜增生。进行了药物涂层球囊血管成形术，NOGA证实紫杉醇沉积。该病例突出了NOGA在直接观察新生内膜变化和药物递送方面的实用性，这是单独血管内超声无法评估的。这是首例使用NOGA证明肺静脉支架内再狭窄及药物涂层球囊术后变化的报告。
