Successful Intravascular Lithotripsy Use for Acute Stent Underexpansion in Saphenous Vein Grafts.

成功的血管内碎石术用于大隐静脉移植物急性支架扩张。

• 发表时间: 2024 Feb
• 来源期刊: J Soc Cardiovasc Angiogr Interv
• DOI: 10.1016/j.jscai.2023.101248
• PMID: 39132212
• 文章类型: Case Reports
• 作者列表: Roy S,Bakhshi H,Wagle A,Lawson B,Miller J,Resar J,Johnston PV

关键词: coronary angiography; coronary artery bypass; percutaneous coronary intervention

Abstract

Experience with intravascular lithotripsy (IVL) following stent deployment in saphenous vein graft (SVG) lesions is limited. We present 2 cases of percutaneous intervention in SVG in which acute stent underexpansion was successfully managed with IVL. In the first case, recalcitrant plaque required prestent deployment IVL, with intracoronary imaging showing persistent calcification. Additional poststent deployment IVL facilitated full expansion and successful stent delivery. In the second case, predilation with semicompliant balloons appeared angiographically effective, but stent deployment showed acute underexpansion. Postdilation with noncompliant balloons and ultimately IVL allowed full expansion and successful stent delivery. These are the first reported cases of IVL use immediately after stent deployment in SVG to treat underexpansion due to recalcitrant calcification.

摘要

在隐静脉移植物（SVG）病变中展开支架后进行血管内碎石（IVL）的经验有限。我们介绍了2例SVG经皮介入治疗，其中IVL成功治疗了急性支架膨胀不足。在第一种情况下,顽固性斑块需要支架前展开IVL，冠状动脉成像显示持续性钙化。额外的支架展开后IVL促进了完全扩张和成功的支架输送。在第二种情况下，使用半弯曲球囊的预扩张在血管造影上似乎是有效的，但支架展开显示急性膨胀不足。使用非顺应性球囊的后扩张和最终IVL允许完全扩张和成功的支架输送。这是首次报道的在SVG中展开支架后立即使用IVL治疗由于顽固性钙化引起的扩张不足的病例。