Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2026
Coronary Perforation During Excimer Laser Angioplasty in a Patient With Prior Thoracic Radiotherapy.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Sparasci Francesco Maria, Cafaro Alessandro, Fischetti Dionigi, Mandurino-Mirizzi Alessandro
Аннотация
BACKGROUND: Management of heavily calcified coronary lesions remains challenging despite advances in plaque-modifying technologies. Excimer laser coronary angioplasty (ELCA) is an effective adjunctive strategy with a low risk of no-reflow.
CASE SUMMARY: A 75-year-old woman with non-ST-segment elevation acute coronary syndrome and severe left ventricular dysfunction, previously treated with thoracic radiotherapy, underwent percutaneous coronary intervention of a calcified left anterior descending artery lesion. Optical coherence tomography revealed an eruptive calcified nodule with thrombus and a concentric stenosis. ELCA was selected to minimize distal embolization; however, the procedure was complicated by multiple coronary perforations requiring covered stent implantation.
DISCUSSION: This case suggests that coronary perforation during ELCA may result from the interplay between lesion complexity, procedural factors, and radiation-related vessel wall remodeling.
CASE SUMMARY: A 75-year-old woman with non-ST-segment elevation acute coronary syndrome and severe left ventricular dysfunction, previously treated with thoracic radiotherapy, underwent percutaneous coronary intervention of a calcified left anterior descending artery lesion. Optical coherence tomography revealed an eruptive calcified nodule with thrombus and a concentric stenosis. ELCA was selected to minimize distal embolization; however, the procedure was complicated by multiple coronary perforations requiring covered stent implantation.
DISCUSSION: This case suggests that coronary perforation during ELCA may result from the interplay between lesion complexity, procedural factors, and radiation-related vessel wall remodeling.
Предметные рубрики MeSH
HumansFemaleAgedLasers, ExcimerTreatment OutcomeCoronary VesselsVascular CalcificationCoronary AngiographyHeart InjuriesStentsRadiation InjuriesAcute Coronary SyndromeNon-ST Elevated Myocardial InfarctionTomography, Optical CoherenceVascular System InjuriesAngioplasty, Balloon, CoronaryCoronary Artery DiseaseRadiotherapy