Bail-out unexpanded stent implantation in acute leftmain dissection treated with intra coronary lithotripsy: a case report
Bail-out unexpanded stent implantation in acute leftmain dissection treated with intra coronary lithotripsy: a case report
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DOI：
10.1093/ehjcr/ytz172
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发表时间：
2019-12-01
影响因子：
1
通讯作者：
Rametta, Francesco
中科院分区：
文献类型：
--
作者：
Tumminello, Gabriele;Cavallino, Chiara;Rametta, Francesco
背景严重钙化冠状动脉病变的经皮治疗具有挑战性，并发症发生率高。不可扩张支架是最严重的并发症之一。这两种情况可能受益于冠状动脉内碎石术（ICL-ShockwaveVR），一种新的冠状动脉经皮technique.Case summary这一病例报告描述了一名男子经皮冠状动脉介入治疗（PCI）左主干（LM）严重钙化病变。PCI因LM在不完全扩张病变中的巨大夹层而复杂化。在残余未扩张的情况下进行了紧急支架植入术。ICL允许急性扩张支架，并获得最佳的最终结果。讨论熟悉专用技术和设备来治疗钙化冠状动脉病变是执行高风险复杂PCI的基础。该病例强调了新ICL技术治疗钙化病变或相关并发症（如不可扩张支架）的潜在有用性。
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-ShockwaveVR), 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.