Recurrent In-Stent Restenosis and Accelerated Neoatherosclerosis in a Middle-Aged Woman With High Inflammatory Burden.

Authors

Wenhao Li, Wenqi Han, Zhenyu Wang

Published in

JACC. Case reports. Pages 110991. Oct 16, 2026. Epub Oct 16, 2026.

Abstract

Recurrent in-stent restenosis (ISR) driven by accelerated neoatherosclerosis and high residual inflammatory risk remains a formidable clinical challenge.
A 50-year-old noncompliant, obese, diabetic woman presented with recurrent multivessel ISR. Intravascular ultrasound confirmed intrastent thin-cap fibroatheromas. Despite multiple drug-coated balloon interventions, intensive lipid-lowering via inclisiran, and glycemic control with tirzepatide, she suffered relentless ISR driven by highly elevated interleukin-6. She received advanced anti-inflammatory therapies and was referred for bypass surgery.
Literature highlights that targeting upstream inflammation is critical when standard therapies fail to halt malignant neoatherosclerosis. This case interests readers by demonstrating compliance optimization via long-acting agents and navigating advanced anti-inflammatory pathways (colchicine escalation, canakinumab) for refractory ISR.
Biomarkers like interleukin-6 must be evaluated in refractory ISR; persistent residual inflammation warrants advanced anti-inflammatory therapies or early surgical revascularization.

PMID:
42886143
Bibliographic data and abstract were imported from PubMed on 16 Oct 2026.

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