Intravascular lithotripsy to treat an underexpanded coronary stent: 4-Month angiographic and OCT follow-up

Catheter Cardiovasc Interv. 2020 Nov;96(6):1251-1257. doi: 10.1002/ccd.28738. Epub 2020 Jan 20.

Abstract

We report the case of a 79-year-old man with stable angina who underwent percutaneous coronary intervention to a severe and calcified left circumflex lesion. Despite extensive preparation of the lesion with high-pressure balloon predilatation and rotablation, the implanted stent was grossly underexpanded and failed to respond to high-pressure balloon postdilatation. The patient was readmitted 6 weeks later for intravascular lithotripsy that resulted in excellent stent expansion. Coronary angiography with optical coherence tomography 4 months later revealed sustained acute lumen gain with no evidence of stent recoil or in-stent restenosis.

Keywords: coronary calcification; non-expandable lesions; rotablation.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Angioplasty, Balloon, Coronary / adverse effects
  • Angioplasty, Balloon, Coronary / instrumentation*
  • Coronary Angiography*
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / therapy*
  • Coronary Vessels / diagnostic imaging*
  • Humans
  • Lithotripsy*
  • Male
  • Predictive Value of Tests
  • Severity of Illness Index
  • Stents*
  • Time Factors
  • Tomography, Optical Coherence*
  • Treatment Outcome
  • Vascular Calcification / diagnostic imaging
  • Vascular Calcification / therapy*