Rotational atherectomy (stentablation) in a lesion with stent underexpansion due to heavily calcified plaque.
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.
Kobayashi
Y
Y
Lenox Hill Heart and Vascular Institute, New York, New York 10021, USA.
Teirstein
P
P
Linnemeier
T
T
Stone
G
G
Leon
M
M
Moses
J
J
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