JACC Case Rep. 2026 Oct 9:110636. doi: 10.1016/j.jaccas.2026.110636. Online ahead of print.
ABSTRACT
BACKGROUND: Triglyceride deposit cardiomyovasculopathy (TGCV) causes triglyceride accumulation in cardiomyocytes and vascular smooth muscle cells, leading to diffuse coronary artery disease and frequent restenosis after percutaneous coronary intervention.
CASE SUMMARY: A 37-year-old man with diabetes mellitus presented with diffuse 3-vessel coronary disease. Angiography and computed tomography revealed concentric diffuse coronary stenoses, and intravascular ultrasound demonstrated periadventitial low-echoic structures. Iodine-123-β-methyl-iodophenyl pentadecanoic acid scintigraphy showed a severely reduced washout rate, supporting the diagnosis of TGCV. The patient underwent percutaneous coronary intervention using a cutting balloon followed by drug-coated balloon angioplasty without stent implantation. No restenosis was observed by angiography at 1 year or computed tomography at 3 years.
DISCUSSION: This case suggests that a stentless revascularization strategy using a drug-coated balloon may be a feasible option in TGCV, potentially avoiding pathological vascular responses associated with permanent metallic scaffolds.
TAKE-HOME MESSAGE: Stentless intervention may represent a promising therapeutic option in patients with TGCV.
PMID:42853169 | DOI:10.1016/j.jaccas.2026.110636