Successful Management of Stent Underexpansion Using Intravascular Lithotripsy Followed by High-Pressure Balloon Dilation.

Stent underexpansion is a significant risk factor for stent thrombosis and restenosis. The efficacy and safety of intravascular lithotripsy (IVL) after stent implantation have not been well established. This report presents a case of a 60-year-old man with non-ST elevation myocardial infarction who underwent emergency revascularization for a severely calcified lesion in the left circumflex artery. Despite initial stent implantation, intravascular ultrasound demonstrated stent underexpansion. IVL was employed as a bailout strategy, followed by high-pressure balloon dilation. This case highlights the potential of IVL, in conjunction with high-pressure balloon dilation, as a safe and effective treatment option for stent underexpansion in severely calcified lesions.