Related Experiment Video
Updated: Dec 31, 2025
Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
Bail-out unexpanded stent implantation in acute left main dissection treated with intra coronary lithotripsy: a case
Gabriele Tumminello1, Chiara Cavallino1, Andrea Demarchi1
1Division of Cardiology, S. Andrea Hospital, Corso Mario Abbiate 21, 13100 Vercelli, Italy.
Insights
Intracoronary lithotripsy (ICL) offers a new solution for challenging heavily calcified coronary lesions. This technique successfully treated a complex case of left main dissection and unexpandable stent, achieving an optimal outcome.
Area of Science:
- Interventional Cardiology
- Cardiovascular Devices
Background:
- Percutaneous treatment of heavily calcified coronary lesions is complex and carries a high risk of complications.
- Stent under-expansion is a significant complication that can arise during percutaneous coronary intervention (PCI).
- Intracoronary lithotripsy (ICL) is an emerging technique for managing calcified lesions.
Background:
The percutaneous treatment of heavily calcified coronary lesions is challenging and presents high rate of complications. Unexpandable stent is one of the most serious complication. Both of these conditions may benefit from the intracoronary lithotripsy (ICL-Shockwave®), a new coronary percutaneous technique.
Case Summary:
This case report describes a man treated with percutaneous coronary intervention (PCI) for a left main (LM) severe calcified lesion. The PCI was complicated by a huge dissection of LM in a not completely expandable lesion. A bail-out stent implantation was performed with residual unexpansion. The ICL permitted to expand acutely the stent and obtain an optimal final result.
Discussion:
Familiarity with dedicated techniques and devices to treat calcified coronary lesions is fundamental to perform high-risk complex PCI. This case emphasizes the potential usefulness of the new ICL technique to treat calcified lesions or related complications like unexpandable stent.
Related Concept Videos
01:30Acute Coronary Syndrome I: Introduction
01:28Acute Coronary Syndrome IV: Interprofessional Care