Rohit Mody: Subacute Stent Thrombosis with IVUS Guided Diagnosis and ELCA Treatment
Rohit Mody, HOD and Director Cardiology at Mody Cardiac Institute and Research Centre, Bathinda, shared a post on LinkedIn:
“55-year-old. Subacute stent thrombosis. A mechanical failure, not just a drug failure.
Under-deployed, overlapping, malapposed stents lead to a perfect setup for thrombosis.
We avoided the usual reflexes (no POBA, no thrombus aspiration).
Went early with Intravascular Ultrasound to understand the problem.
Then came the game changer – Excimer Laser Coronary Atherectomy (ELCA).
Why ELCA made the difference
- Melts thrombus, doesn’t push it leading to heavy clot becoming a mild burden
- No distal embolization, leading to diagonals preserved
- Makes lesion workable, changing it from hostile to treatable
- Repeatable tooll, so in re-thrombosis after IVUS, another ELCA run, clean again
- Less trauma, avoiding aggressive ballooning in thrombus-rich setting
- Improves imaging, resulting in clearer IVUS and better decisions
Final step:
IVUS-guided optimization and targeted stenting corrected the real problem (underexpansion and malapposition)
Take-home
Subacute thrombosis is often a stent problem, not just a clot problem.
ELCA doesn’t just treat thrombus — it creates control.
Fix the cause, not just the consequence.”

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