Rotational atherectomy for treatment of in-stent restenosis: role of intracoronary ultrasound guidance.

In-stent restenosis is becoming increasingly frequent as greater numbers of intracoronary stents are implanted, and may pose a particularly challenging management problem. Recurrent restenosis following balloon angioplasty for in-stent restenosis is common, and thus the possible role of debulking has been considered. This report describes the successful treatment of severe restenosis within a Palmaz-Schatz stent with high-speed rotational atherectomy, using intracoronary ultrasound guidance.