Turk Kardiyol Dern Ars. 2020; 48(8): 766-770 | DOI: 10.5543/tkda.2020.00015

Successful dilatation of underexpanded stent with super-high-pressure balloon: A case report

Mesud Jamakovic¹, Kenana Aganovic², Edin Begic^3
1Department for Interventional Cardiology, Clinic for Heart, Blood Vessel and Rheumatic Diseases, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
²Intensive Care Unit, Clinic for Heart, Blood Vessel and Rheumatic Diseases, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
³Department of Pharmacology, School of Medicine, Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina

Dilatation and percutaneous coronary intervention in the presence of calcified lesions is particularly demanding and presents a challenge in the daily work of an interventional cardiologist. Coronary calcification is a marker of the progress of the atherosclerotic process. The existence of calcifying lesions predicts a poorer clinical outcome and is associated with increased mortality and the occurrence of postprocedural major adverse cardiovascular events (MACEs). A male patient who was 61 years old was admitted as a result of ST-elevation myocardial infarction (STEMI) complicated by cardiac arrest caused by in-stent thrombosis of a previously suboptimally expanded stent. The lesion did not respond to a dilation attempt with a noncompliant (NC) balloon; however, an optimal result was obtained with inflation from a super-high-pressure NC balloon (OPN NC) for ultra-high-pressure inflations. Resistant, calcified lesions require a careful and comprehensive approach. The OPN NC balloon has a place in the treatment of this type of lesion. An optimized therapeutic modality after the procedure is imperative to prevent a MACE.

Keywords: In-stent thrombosis, OPN balloon; ST-elevation myocardial infarction; stent underexpansion.

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