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.
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