title: High energy excimer laser to treat coronary in-stent restenosis in an underexpanded stent.
abstract: Balloon refractory calcific coronary plaques remain a technical challenge. Stent underexpansion is known as a major cause of restenosis and thrombosis. We report a case of in-stent restenosis 5 months after stent suboptimal implantation in a noncompliant calcific atherosclerotic plaque which could not be disrupted by repeated prolonged high-pressure balloon inflations. High-energy excimer laser use altered underlying lesion morphology, allowing full stent apposition. Advances in equipment and technique have allowed more frequent use of high energy excimer laser technology during percutaneous coronary angioplasty with very low rates of complications. Laser technology represents a useful tool to overcome resistant lesions during percutaneous coronary interventions.
authors.affiliation: Department of Medicine, Montreal Heart Institute, Montreal University, Montreal, Quebec, Canada.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Noble
authors.forename: Luc
authors.initials: L
authors.lastname: Bilodeau
mesh_terms: D000787:Angina Pectoris / Q000209:etiology / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation; D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D023921:Coronary Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012720:Severity of Illness Index; D015607:Stents; D017211:Treatment Failure