@article{article_1866180, title={Intravascular lithotripsy for severe underexpansion of overlapping stents in heavily calcified right coronary artery: A case report}, journal={Ege Tıp Dergisi}, volume={65}, pages={340–344}, year={2026}, DOI={10.19161/etd.1866180}, url={https://izlik.org/JA56SR85SE}, author={Polat, Fuat and Terzı, Sait}, keywords={Intravascular lithotripsy, stent underexpansion, coronary calcification, overlapping stents, percutaneous coronary intervention}, abstract={Stent underexpansion due to severe calcification remains a significant challenge in percutaneous coronary intervention, particularly in patients with overlapping stents. We aimed to demonstrate the efficacy of intravascular lithotripsy in managing refractory stent underexpansion when conventional techniques fail. A 71-year-old male with multiple cardiovascular risk factors and prior coronary artery bypass grafting presented with recurrent angina due to severe underexpansion of overlapping stents in the mid-right coronary artery. Despite aggressive preparation with non-compliant and cutting balloons across multiple sessions, adequate stent expansion could not be achieved. Intravascular ultrasound revealed circumferential calcification extending 270 degrees around the vessel with double-layered underexpanded stents. Intravascular lithotripsy was employed followed by high-pressure balloon dilatation to achieve optimal stent expansion. The patient tolerated the procedure without complications and reported complete resolution of anginal symptoms at post-discharge follow-up. This case demonstrates that intravascular lithotripsy is a highly effective and safe treatment option for severe stent underexpansion in the setting of heavy circumferential calcification when conventional balloon-based techniques fail.}, number={2}