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Intravascular lithotripsy for severe underexpansion of overlapping stents in heavily calcified right coronary artery: A case report
Abstract
Stent underexpansion due to severe calcification remains a significant challenge in percutaneous coronary intervention, particularly in patients with overlapping stents. We aimed to demonstrate the efficacy of intravascular lithotripsy in managing refractory stent underexpansion when conventional techniques fail.
A 71-year-old male with multiple cardiovascular risk factors and prior coronary artery bypass grafting presented with recurrent angina due to severe underexpansion of overlapping stents in the mid-right coronary artery. Despite aggressive preparation with non-compliant and cutting balloons across multiple sessions, adequate stent expansion could not be achieved. Intravascular ultrasound revealed circumferential calcification extending 270 degrees around the vessel with double-layered underexpanded stents. Intravascular lithotripsy was employed followed by high-pressure balloon dilatation to achieve optimal stent expansion. The patient tolerated the procedure without complications and reported complete resolution of anginal symptoms at post-discharge follow-up.
This case demonstrates that intravascular lithotripsy is a highly effective and safe treatment option for severe stent underexpansion in the setting of heavy circumferential calcification when conventional balloon-based techniques fail.
Keywords
Ethical Statement
Ethics committee approval is not required for this case report according to the institutional guidelines
References
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Details
Primary Language
English
Subjects
Clinical Sciences (Other)
Journal Section
Case Report
Publication Date
June 10, 2026
Submission Date
January 18, 2026
Acceptance Date
March 3, 2026
Published in Issue
Year 2026 Volume: 65 Number: 2
APA
Polat, F., & Terzı, S. (2026). Intravascular lithotripsy for severe underexpansion of overlapping stents in heavily calcified right coronary artery: A case report. Ege Tıp Dergisi, 65(2), 340-344. https://doi.org/10.19161/etd.1866180
AMA
1.Polat F, Terzı S. Intravascular lithotripsy for severe underexpansion of overlapping stents in heavily calcified right coronary artery: A case report. EJM. 2026;65(2):340-344. doi:10.19161/etd.1866180
Chicago
Polat, Fuat, and Sait Terzı. 2026. “Intravascular Lithotripsy for Severe Underexpansion of Overlapping Stents in Heavily Calcified Right Coronary Artery: A Case Report”. Ege Tıp Dergisi 65 (2): 340-44. https://doi.org/10.19161/etd.1866180.
EndNote
Polat F, Terzı S (June 1, 2026) Intravascular lithotripsy for severe underexpansion of overlapping stents in heavily calcified right coronary artery: A case report. Ege Tıp Dergisi 65 2 340–344.
IEEE
[1]F. Polat and S. Terzı, “Intravascular lithotripsy for severe underexpansion of overlapping stents in heavily calcified right coronary artery: A case report”, EJM, vol. 65, no. 2, pp. 340–344, June 2026, doi: 10.19161/etd.1866180.
ISNAD
Polat, Fuat - Terzı, Sait. “Intravascular Lithotripsy for Severe Underexpansion of Overlapping Stents in Heavily Calcified Right Coronary Artery: A Case Report”. Ege Tıp Dergisi 65/2 (June 1, 2026): 340-344. https://doi.org/10.19161/etd.1866180.
JAMA
1.Polat F, Terzı S. Intravascular lithotripsy for severe underexpansion of overlapping stents in heavily calcified right coronary artery: A case report. EJM. 2026;65:340–344.
MLA
Polat, Fuat, and Sait Terzı. “Intravascular Lithotripsy for Severe Underexpansion of Overlapping Stents in Heavily Calcified Right Coronary Artery: A Case Report”. Ege Tıp Dergisi, vol. 65, no. 2, June 2026, pp. 340-4, doi:10.19161/etd.1866180.
Vancouver
1.Fuat Polat, Sait Terzı. Intravascular lithotripsy for severe underexpansion of overlapping stents in heavily calcified right coronary artery: A case report. EJM. 2026 Jun. 1;65(2):340-4. doi:10.19161/etd.1866180