Bail-out therapy in ST-segment elevation myocardial infarction due to calcified lesion causing stent underexpansion: Intravascular lithotripsy is in the lead
| Autor: | Muhammad Khaled Luttoo, Thomas Baudinet, Benjamin Seguy, Edouard Gerbaud, Laura Cetran, Pierre Coste |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
business.industry medicine.medical_treatment Stent Context (language use) Case Report 030204 cardiovascular system & hematology Lithotripsy Balloon medicine.disease 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Cardiology ST segment 030212 general & internal medicine Artery occlusion Cutting balloon Myocardial infarction Cardiology and Cardiovascular Medicine business |
| Zdroj: | J Cardiol Cases |
| Popis: | A 52-year-old male was referred for an acute anterior ST-segment elevation myocardial infarction (STEMI). Coronary angiography revealed an acute left anterior descending artery occlusion. The patient was treated with a drug-eluting stent (DES). Despite long and repeated high-pressure inflations (>20 atm) of non-compliant balloons, OPN NC(Ⓡ) high-pressure balloon (SIS Medical AG; Frauenfeld, Switzerland), rotational atherectomy, and cutting balloon, there was a severe hourglass stent underexpansion caused by coronary calcification. Thus, intravascular lithotripsy (IVL) (Shockwave Medical, Fremont, CA, USA) was attempted to re-dilate this calcified lesion. Underexpansion was successfully treated after delivering 70 shockwaves to the narrowest segment. IVL delivers localized pulsatile sonic pressure waves inducing circumferential calcium modification and multiple fractures. Our observation illustrates the additional value of coronary lithotripsy as a bail-out procedure to tackle severely calcified, de novo coronary lesions causing stent underexpansion in the context of STEMI, when all other available techniques failed. |
| Databáze: | OpenAIRE |
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