Balloon pin-hole rupture during percutaneous coronary intervention for recurrent, calcified in-stent restenosis: A case report.
Percutaneous coronary intervention (PCI) for patients with in-stent restenosis (ISR) is generally considered safe and effective. However, due to increased tissue hardness, PCI for calcified intra-stent ISR is technically challenging. Here, we report severe angioplasty-related complications in a patient presenting with calcified, recurrent ISR following PCI. After receiving drug-coated balloon (DCB) angioplasty for an initial ISR, the patient developed recurrent ISR during the follow-up period. Intravascular imaging revealed intra-stent calcifications and balloon angioplasty was subsequently performed. During the angioplasty, a pin-hole balloon rupture occurred, consequently causing coronary dissection as visualized by intravascular imaging. To prevent acute coronary occlusion, stent implantation was required. The present case report suggests that, following detection of intra-stent calcified stenosis, both careful balloon inflation as well as optimal ablation device selection are required to prevent potential complications and obtain successful procedural outcomes.
['Murata|Nobuhiro|N|0000-0003-0362-4268', 'Takayama|Tadateru|T|', 'Hiro|Takafumi|T|', 'Hirayama|Atsushi|A|']
D015906:Angioplasty, Balloon, Coronary D062906:Cardiac Catheters D017023:Coronary Angiography D023903:Coronary Restenosis D054855:Drug-Eluting Stents D004867:Equipment Design D004868:Equipment Failure D006801:Humans D008297:Male D008875:Middle Aged D062645:Percutaneous Coronary Intervention D012008:Recurrence D041623:Tomography, Optical Coherence D016896:Treatment Outcome D018084:Ultrasonography, Interventional D061205:Vascular Calcification
coronary PCI complications imaging IVUS angiography optical coherence tomography