Book review
https://doi.org/10.20471/acc.2024.63.s1.22
Case Report: To Stop on Time – One of the Hardest Decisions: ‘Loss’ of the Stent in a Calcified RCA
Ivan Rosović
; Thalassotherapia Opatija – Clinic for rehabilitation, treatment and prevention of heart and blood vessels diseases, Opatija, Croatia
*
Damir Avdagić
; Thalassotherapia Opatija – Clinic for rehabilitation, treatment and prevention of heart and blood vessels diseases, Opatija, Croatia
Rajko Miškulin
; Thalassotherapia Opatija – Clinic for rehabilitation, treatment and prevention of heart and blood vessels diseases, Opatija, Croatia
* Corresponding author.
Abstract
A case report of a 63-year-old man who was indicated for invasive coronarography
during outpatient treatment. The completed coronarography confirmed a significant stenosis in the highly
calcified right coronary artery (RCA). In order to determine the hemodynamic significance of the borderline
significant stenosis of the curved branch of the left coronary artery, FFR was performed. Despite
the use of non-compliance balloons and high-pressure OPN balloons during elective PCI-RCA, the
lesion in question could not be predilated, resulting in the need for the patient to undergo PCI-RCA with
rotablation. During the repeated PCI-RCA procedure, the proximal and middle segments were subjected
to rotablation. Non-compliant balloon catheters were used to perform a successful predilatation of the
middle segment lesion and to try to place a stent in the designated lesion. Due to the calcified curve of the
proximal segment, the stent was unable to pass through while being retracted into the leading catheter,
causing it to fall into the proximal segment. The stent balloon was used to push the stent and insert it into
the curve between the proximal and middle segment. A small balloon catheter (1.2 x 15 mm) successfully
passed through the unexpanded stent. After subsequent inflating of the small balloon catheter and
further inflating of larger balloons the lost stent was fully expanded and implanted with optimal control
coronarography findings.
Keywords
Coronary artery calcification; Rotablation; High-pressure OPN balloon
Hrčak ID:
321432
URI
Publication date:
1.3.2024.
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