1. Excimer Laser Angioplasty–Facilitated Fracturing of Napkin-Ring Peri-Stent Calcium in a Chronically Underexpanded Stent Documentation by Optical Coherence Tomography

    Excimer Laser Angioplasty–Facilitated Fracturing of Napkin-Ring Peri-Stent Calcium in a Chronically Underexpanded Stent Documentation by Optical Coherence Tomography

    A 79-year-old man underwent stent implantation into a severely calcified proximal left anterior descending coronary lesion ( Figure 1 ) in December 2012 followed by restenting in March 2014 to treat in-stent restenosis ( Figure 2 ), both without full balloon expansion. Optical coherence tomography (OCT) documented thick, peri-stent napkin-ring calcium. He was admitted for recurrent unstable angina in April 2014. After initial treatment with excimer laser coronary angioplasty (ELCA; 1.4 mm, Spectranetics Corporation, Colorado Springs, Colorado) using saline injection, fluence of 60 mJ/mm 2 , and frequency of 80 Hz, a balloon was fully expanded. OCT showed fracturing of peri-stent calcium and ...

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