Assuntos
Angioplastia Coronária com Balão , Aterectomia Coronária , Doença da Artéria Coronariana , Litotripsia , Calcificação Vascular , Humanos , Aterectomia Coronária/efeitos adversos , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/terapia , Angioplastia Coronária com Balão/efeitos adversos , Coração , Resultado do Tratamento , Calcificação Vascular/diagnóstico por imagem , Calcificação Vascular/terapia , Angiografia CoronáriaRESUMO
Stent underexpansion is a common problem in heavily calcified coronary lesions treated with percutaneous coronary intervention, and has been associated with in-stent restenosis, stent thrombosis and, subsequently, poor clinical outcomes. Adequate preparation of heavily calcified coronary lesions (e.g. using non-compliant balloons, cutting/scoring balloons, rotational/orbital atherectomy or intravascular lithotripsy) prior to stent implantation is essential in preventing stent underexpansion. However, in certain cases the deployed stent may remain underexpanded despite extensive lesion preparation. To date, no consensus exists on how to treat stent underexpansion in this scenario. We present a cases series in which post-stenting intravascular lithotripsy was performed to treat acute stent underexpansion in heavily calcified lesions, describing the technical aspects, angiographic results as well as clinical outcomes at mid-term follow-up.