Coronary Artery Perforation After Balloon Dilatation for Recurrent In-Stent Restenosis Inside the Double-Layered...

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Medical Complications

Background:

• Percutaneous coronary intervention (PCI) is a common procedure for coronary artery disease.
• In-stent restenosis (ISR) is a known complication following PCI, often requiring re-intervention.
• Coronary artery perforation is a rare but potentially fatal complication of PCI.

Purpose of the Study:

• To report a rare case of coronary artery perforation.
• To describe the occurrence of perforation in a specific context: recurrent in-stent restenosis with calcified nodules within double-layered stents.
• To emphasize the advanced nature of this complication and its management challenges.

Main Methods:

• Case presentation of a patient undergoing balloon dilatation for recurrent in-stent restenosis.
• Detailed description of the lesion characteristics, including calcified nodule and double-layered stents.
• Documentation of the subsequent coronary artery perforation event.

Main Results:

• Coronary artery perforation occurred following balloon angioplasty for the complex in-stent restenotic lesion.
• The lesion was characterized by a calcified nodule within previously implanted double-layered stents.
• This event underscores the potential for severe complications even in challenging restenotic scenarios.

Conclusions:

• Coronary artery perforation, though rare, can occur during interventions for complex in-stent restenotic lesions.
• The presence of calcified nodules and layered stents may increase procedural risks.
• This case highlights the need for careful assessment and advanced techniques in managing challenging restenotic lesions.