Rotational atherectomy (stentablation) in a lesion with stent underexpansion due to heavily calcified plaque

Catheter Cardiovasc Interv. 2001 Feb;52(2):208-11. doi: 10.1002/1522-726x(200102)52:2<208::aid-ccd1049>3.0.co;2-h.

Abstract

We report treatment of a lesion with coronary stent underexpansion due to heavily calcified plaque. Conventional balloon angioplasty was attempted for in-stent restenosis, but the lesion was undilatable despite 25-atm inflation pressure. Intravascular ultrasound (IVUS) revealed stent underexpansion due to heavily calcified plaque. Rotational atherectomy was performed using a stepped burr approach, after which repeat IVUS revealed marked ablation of the stent-calcium complex. Adjunctive balloon angioplasty then easily resulted in full balloon and stent expansion, with an excellent angiographic and IVUS result. The patient's hospital course was uneventful.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Angioplasty, Balloon, Coronary
  • Atherectomy, Coronary / methods*
  • Coronary Angiography
  • Coronary Disease / diagnosis
  • Coronary Disease / therapy*
  • Coronary Vessels / diagnostic imaging
  • Humans
  • Male
  • Stents*
  • Ultrasonography, Interventional