In-stent restenosis(ISR) lesions are very difficult to deal with, there is still no satisfied or accepted methods for now, we investigated the efficiency and safety of excimer laser coronary atherectomy（ELCA) used in ISR recently.

From Dec 1, 2017 to Dec 1, 2018, 11 patients treated by ELCA for ISR were included, 4 of them (36.4%) were chronic total occlusions. The size of laser catheters was selected according to the diameter of the vessels and stenosis percentage, then subsequent treatment with balloon angioplasty, drug eluting balloons and/or drug eluting stents. Quantitative coronary angiography (QCA) was used to measure the diameter of the vessels before ELCA, after ELCA, and the final coronary angiography. All the patients were observed during hospitalization, and followed up 9 months later by phone.

All the patients got procedure success after operation; average minimal lumen diameter increased from 0.90±0.74mm to 1.56±0.50mm (p<0.05) after ELCA. There were no acute vessel closures, no dissections, but 2 perforations (type Ellis II) without special treatment. There were no death, acute myocardial infarction and target lesion revascularization during hospitalization. At 9-month follow-up, there was also no death, myocardial infarction, but 2 patients got target lesion revascularization.

ELCA was an efficient and safe treatment for complex in-stent restenosis lesions, ELCA can increase the diameter of the vessels obviously, and can achieve satisfied immediate and 9 months results.