Successful double-layer metal stents rotational ablation under 2-dimensional and 3-dimensional optical coherence tomography guidance: a case report

BMC Cardiovascular Disorders

Zhang Cheng¹  Zhao Yanan¹  Du Beibei¹  He Yuquan¹  Liu Guohui¹  Yang Ping¹  Tong Yaliang¹ 

[1] Department of Cardiology, China-Japan Union Hospital of Jilin University, Xiantai Street No. 126, Changchun, Jilin, China;Jilin Provincial Cardiovascular Research Institute, Changchun, Jilin, China;Jilin Provincial Precision Medicine Key Laboratory for Cardiovascular Genetic Diagnosis, Changchun, Jilin, China;

关键词: Calcified plaque;    Stent underexpansion;    Rotational atherectomy;    Stent ablation;    Optical coherence tomography;   

DOI  :  10.1186/s12872-021-01965-z

来源: Springer

【 摘 要 】

BackgroundStent ablation with rotational atherectomy has been considered a bail-out strategy for the treatment of severe stent underexpansion. Only a few reports have yet shown rotational ablation for double-layer metal struts.Case presentationWe present a case of 80-year-old female patient presented to our hospital because of worsening effort angina. Coronary angiography revealed severe in-stent restenosis in the proximal left anterior descending artery. Optical coherence tomography (OCT) examinations found that severe stenosis occurred at the overlap region with 2-layer underexpanded stents and circumferential calcification beneath them. Under the guidance of 2-dimensional (2D) and 3-dimensional (3D) OCT, we successfully performed percutaneous coronary intervention (PCI) of this lesion after adequate stent ablation, high-pressure balloon dilatation, and subsequent everolimus-eluting stent implantation. The patient recovered well uneventfully and discharged from hospital 7 days later. No restenosis occurred after 12 months.ConclusionsWe report a very rare case of in-stent restenosis due to double-layer underexpanded stents. The entire percutaneous coronary intervention procedure was performed step by step under the guidance of high-resolution OCT. Our findings highlight the specific value of 2D and 3D OCT guidance in double-layer stents rotational ablation.

【 授权许可】

CC BY