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Successful dilatation of underexpanded stent with super-high-pressure balloon: A case report
Mesud Jamakovic1, Kenana Aganovic2, Edin Begic3
1Department for Interventional Cardiology, Clinic for Heart, Blood Vessel and Rheumatic Diseases, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
Insights
Treating calcified coronary lesions is challenging. An ultra-high-pressure balloon effectively dilated a resistant lesion, demonstrating its value in complex percutaneous coronary interventions to prevent adverse events.
Area of Science:
- Interventional Cardiology
- Cardiovascular Medicine
- Atherosclerosis Research
Background:
- Coronary calcification signifies advanced atherosclerosis, predicting poor outcomes and increased mortality.
- Calcified lesions pose significant challenges during percutaneous coronary intervention (PCI).
- Suboptimal stent expansion in calcified lesions can lead to complications like in-stent thrombosis.
Abstract:
Dilatation and percutaneous coronary intervention in the presence of calcified lesions is particularly demanding and presents a challenge in the daily work of an interventional cardiologist. Coronary calcification is a marker of the progress of the atherosclerotic process. The existence of calcifying lesions predicts a poorer clinical outcome and is associated with increased mortality and the occurrence of postprocedural major adverse cardiovascular events (MACEs). A male patient who was 61 years old was admitted as a result of ST-elevation myocardial infarction (STEMI) complicated by cardiac arrest caused by in-stent thrombosis of a previously suboptimally expanded stent. The lesion did not respond to a dilation attempt with a noncompliant (NC) balloon; however, an optimal result was obtained with inflation from a super-high-pressure NC balloon (OPN NC) for ultra-high-pressure inflations. Resistant, calcified lesions require a careful and comprehensive approach. The OPN NC balloon has a place in the treatment of this type of lesion. An optimized therapeutic modality after the procedure is imperative to prevent a MACE.
