The last resort during complex retrograde percutaneous coronary chronic total occlusion intervention: Extraplaque intracoronary lithotripsy to externally crush a heavy calcified occluded stent

Catheter Cardiovasc Interv. 2022 Feb;99(2):497-501. doi: 10.1002/ccd.30050. Epub 2021 Dec 23.

Abstract

Chronic total occlusions (CTO) due to in-stent restenosis represent a challenging lesion subset for percutaneous coronary intervention in particular when associated with coronary calcification. Sometimes CTO lesions require antegrade or retrograde dissection-re-entry techniques with extraplaque dilation. Recently intravascular lithotripsy (IVL) emerged as a therapeutic option for the treatment of severely calcified coronary lesions but its role in extraplaque dilation is not described. In this report, we present a case of retrograde complex percutaneous coronary chronic total occlusion revascularization accomplished by the use of extraplaque IVL necessary to externally crush a heavy calcified previous implanted stent.

Keywords: CTO; interventional devices/innovation (IDI); new devices (in general) (NEWD); percutaneous coronary intervention (PCI).

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Chronic Disease
  • Coronary Angiography
  • Coronary Occlusion* / diagnostic imaging
  • Coronary Occlusion* / therapy
  • Humans
  • Lithotripsy* / methods
  • Percutaneous Coronary Intervention* / adverse effects
  • Percutaneous Coronary Intervention* / methods
  • Stents
  • Treatment Outcome