Book review

https://doi.org/10.20471/acc.2024.63.s1.5

Distal Embolization of Calcified Atherosclerotic Plaque Fragment Resulting in “Balloon Uncrossable Lesion” during Elective Percutaneous Coronary Intervention

Ivica Paulić orcid.org/0009-0003-7514-9985 ; Merkur Clinical Hospital, Zagreb, Croatia *
Joško Bulum ; University of Zagreb School of Medicine, Zagreb, Croatia; University Hospital Centre Zagreb, Zagreb, Croatia
Mario Stipinović ; Merkur Clinical Hospital, Zagreb, Croatia
Ivica Premužić Meštrović ; Merkur Clinical Hospital, Zagreb, Croatia
Maro Dragičević ; Merkur Clinical Hospital, Zagreb, Croatia
Tomislav Letilović ; Merkur Clinical Hospital, Zagreb, Croatia; University of Zagreb School of Medicine, Zagreb, Croatia

* Corresponding author.

Abstract

Distal embolization during coronary intervention of thrombotic material resulting
in compromised coronary flow is a common complication usually described in the context of invasive
treatment of the acute ST-segment elevation myocardial infarction (STEMI). In our case we report distal
embolization, presumably with calcified atherosclerotic plaque fragment. It occurred during elective percutaneous
coronary intervention on subostial part of right coronary artery. Fortunately, this embolization
did not compromise distal flow but it resulted in a significant de novo lesion of the right coronary artery
crux. This lesion was uncrossable for dilatation balloons using a variety of different basic and advanced
tools and techniques. Therefore, we decided to perform rotational atherectomy that enabled a successful
percutaneous coronary intervention with stent implantation.

Keywords

PCI (percutaneous coronary intervention); Distal embolization; Calcium; Atherosclerotic plaque; Balloon uncrossable lesion; rotational atherectomy

Hrčak ID:

320947

URI

https://hrcak.srce.hr/320947

Publication date:

1.3.2024.

Article data in other languages: croatian

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