Agent ide study: it was reported that myocardial infarction, occlusion and in-stent restenosis (isr) occurred.On (b)(6) 2022, a 2.50 mm x 12 mm and 3.00 mm x 16 mm promus elite drug eluting stents implanted at the distal left circumflex artery (lcx).On (b)(6) 2023, a 3.50 mm x 28 mm synergy stent was implanted at the first obtuse marginal artery (om1).On(b)(6) 2024, the subject presented to emergency department with chief complaint of worsening chest pain prior to arrival for which nitroglycerine and 81 mg aspirin was taken.At the time of event, subject was on aspirin and clopidogrel.The subject was diagnosed with non-st elevation myocardial infarction.The location of myocardial infarction was inferior and lateral and was unknown q wave mi.On (b)(6) 2024, diagnostic coronary angiography revealed 100% occlusion of the mid lcx stent in the proximal segment after the origin of om1 and severe isr in the proximal segment of the saphenous vein graft (svg) to om graft.The 90% isr noted in the svg-om graft was initially dilated with 2.50 mm x 15 mm, 3.00 mm x 20 mm and 3.50 mm x 15 mm nc balloons.The same lesion was treated with a 3.00 mm x 15 mm wolverine cutting balloon and a 3.50 mm x 15 mm nc balloon.Ivus at this point revealed neointimal hyperplasia at the svg-om graft which was previously treated with the 3.50 mm x 28 mm synergy stent.Finally, the lesion was treated with a 3.00 mm x 24 mm synergy drug eluting stent and post dilation was performed with 3.50 mm x 20 mm nc balloons.The residual stenosis was 0% stenosis.The event was considered as recovered/resolved.The subject was discharged.
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