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Rotational atherectomy ablation for an unexpandable stent under the guide of IVUS: A case report

RATIONALE: Inadequate stent expansion due to rigid calcified may result in restenosis lesions, but the available options are limited. PATIENT CONCERNS: We report a case via the trans-radial approach of the severely underexpanded freshly deployed stent due to heavily calcified plaques DIAGNOSES: Coro...

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Detalles Bibliográficos
Autores principales: Si, Daoyuan, Liu, Guohui, Tong, Yaliang, He, Yuquan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839823/
https://www.ncbi.nlm.nih.gov/pubmed/29443790
http://dx.doi.org/10.1097/MD.0000000000009978
Descripción
Sumario:RATIONALE: Inadequate stent expansion due to rigid calcified may result in restenosis lesions, but the available options are limited. PATIENT CONCERNS: We report a case via the trans-radial approach of the severely underexpanded freshly deployed stent due to heavily calcified plaques DIAGNOSES: Coronary angiography revealed that there was no adequate expansion of the freshly deployed stent. INTERVENTIONS: Under the guide of intravascular ultrasound (IVUS), rotational atherectomy (RA) successfully ablated the stent layers and the protruding calcified plaque. Followed by balloon angioplasty, the ablated segment was scaffolded with another stent, well expanded and documented by IVUS. OUTCOMES: The patient was uneventful during the procedure and remained angina free at the point of one year of clinical follow-up. LESSONS: This case indicated that RA via the trans-radial approach could be a useful remedy in the situation of under-expansion of implanted stents, and the debulking should be performed under IVUS-guidance.