title: Rotational atherectomy (stentablation) in a lesion with stent underexpansion due to heavily calcified plaque.
abstract: We report treatment of a lesion with coronary stent underexpansion due to heavily calcified plaque. Conventional balloon angioplasty was attempted for in-stent restenosis, but the lesion was undilatable despite 25-atm inflation pressure. Intravascular ultrasound (IVUS) revealed stent underexpansion due to heavily calcified plaque. Rotational atherectomy was performed using a stepped burr approach, after which repeat IVUS revealed marked ablation of the stent-calcium complex. Adjunctive balloon angioplasty then easily resulted in full balloon and stent expansion, with an excellent angiographic and IVUS result. The patient's hospital course was uneventful.
authors.affiliation: Lenox Hill Heart and Vascular Institute, New York, New York 10021, USA.
authors.forename: Y
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: P
authors.initials: P
authors.lastname: Teirstein
authors.forename: T
authors.initials: T
authors.lastname: Linnemeier
authors.forename: G
authors.initials: G
authors.lastname: Stone
authors.forename: M
authors.initials: M
authors.lastname: Leon
authors.forename: J
authors.initials: J
authors.lastname: Moses
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017225:Atherectomy, Coronary / Q000379:methods*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D015607:Stents; D018084:Ultrasonography, Interventional