TY  - JOUR
T1  - Intravascular lithotripsy for severe underexpansion of overlapping stents in heavily calcified right coronary artery: A case report
TT  - İleri kalsifik sağ koroner arterde üst üste yerleştirilmiş stentlerde gelişen yetersiz açılımın intravasküler litotripsi ile tedavisi: Olgu sunumu
AU  - Polat, Fuat
AU  - Terzı, Sait
PY  - 2026
DA  - June
Y2  - 2026
DO  - 10.19161/etd.1866180
JF  - Ege Tıp Dergisi
JO  - EJM
PB  - Ege University
WT  - DergiPark
SN  - 1016-9113
SP  - 340
EP  - 344
VL  - 65
IS  - 2
LA  - en
AB  - 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.
KW  - Intravascular lithotripsy
KW  - stent underexpansion
KW  - coronary calcification
KW  - overlapping stents
KW  - percutaneous coronary intervention
N2  - Ağır kalsifikasyon nedeniyle stent yetersiz genişlemesi, özellikle çakışan stentleri olan hastalarda perkütan koroner girişimde önemli bir zorluk olmaya devam etmektedir. Bu vaka sunumunda, geleneksel tekniklerin başarısız olduğu ağır kalsifikasyon varlığında refrakter stent yetersiz genişlemesinin yönetiminde intravasküler litotripsi'nin etkinliğini göstermeyi amaçladık.Yetmiş bir yaşında erkek hasta, çok sayıda kardiyovasküler risk faktörü ve önceden koroner arter baypas greftleme öyküsü ile orta sağ koroner arterdeki çakışan stentlerin ciddi yetersiz genişlemesine bağlı tekrarlayan anjina ile başvurdu. Birden fazla seansta non-compliant ve cutting balonlar ile agresif hazırlığa rağmen yeterli stent genişlemesi sağlanamadı. İntravasküler ultrason ile damar çevresinde 270 derece uzanan sirkümferansiyel kalsifikasyon ve çift katmanlı yetersiz genişlemiş stentler saptandı. İntravasküler litotripsi uygulandı ve ardından yüksek basınçlı balon dilatasyon ile optimal stent genişlemesi başarıldı. Hasta prosedürü komplikasyonsuz tolere etti ve taburculuk sonrası takipte anjinal semptomların tamamen düzeldiğini bildirdi.
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UR  - https://doi.org/10.19161/etd.1866180
L1  - https://dergipark.org.tr/en/download/article-file/5616146
ER  -