Figure 2. OCT images demonstrating distinct tissue patterns in patients with ISR.

A - B) Demonstrate relatively homogeneous severe neointimal proliferation with some confined darker areas close to the underlying stent struts that are readily visualised (bright dots casting a dorsal shadow). C - F) Typical images of neoatherosclerosis. In C and D, a bright superficial intima and a large lipid plaque (dark area with diffuse borders) is demonstrated obscuring the underlying stent struts. A potential diagnosis of an intimal layer infiltrated by macrophages should be considered. In E and F, neoatherosclerosis with intracoronary thrombus is demonstrated. In E, the bright localised image with dorsal shadow (6-7 o’clock) is suggestive of clusters of macrophages. (* denotes wire artefact). ISR: in-stent restenosis; OCT: optical coherence tomography