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Coronary stent fracture and in-stent restenosis due to severe calcification treated with shockwave coronary intravascular lithotripsy with drug eluting balloon

Amarpal Singh Gulati

Background: We report the case of a stent under-expansion and In-Stent Restenosis (ISR) due to a severely calcified lesion at the mid Right Coronary Artery (RCA) treated with the Shockwave Intravascular Lithotripsy (S-IVL) and Drug-Eluting Balloon (DEB).

Methods and findings: A 61-year-old man underwent coronary angiography, and intravascular ultrasound revealed mid-RCA stent under expansion and ISR due to calcified plaque. S-IVL with DEB disrupted the calcium sheet around the stent, thereby allowing optimal stent expansion.

Conclusion: This case demonstrates that S-IVL can successfully treat stent underexpansion and ISR due to heavily calcified lesions in previous stents.