Hou FJ, Ma XT, Zhou YJ, Guan J. Excimer laser coronary atherectomy for a severe calcified coronary ostium lesion: A case report. World J Clin Cases 2021; 9(34): 10666-10670 [PMID: 35004999 DOI: 10.12998/wjcc.v9.i34.10666]
Corresponding Author of This Article
Jun Guan, MD, Dean, Doctor, Professor, Department of Cardiology, Qingdao Municipal Hospital, No. 1 Jiaozhou Road, Qingdao 266000, Shandong Province, China. guanjunslyy@163.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Dec 6, 2021; 9(34): 10666-10670 Published online Dec 6, 2021. doi: 10.12998/wjcc.v9.i34.10666
Excimer laser coronary atherectomy for a severe calcified coronary ostium lesion: A case report
Fang-Jie Hou, Xiao-Teng Ma, Yu-Jie Zhou, Jun Guan
Fang-Jie Hou, Jun Guan, Department of Cardiology, Qingdao Municipal Hospital, Qingdao 266000, Shandong Province, China
Fang-Jie Hou, Xiao-Teng Ma, Yu-Jie Zhou, Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
Author contributions: Hou FJ followed up the patient and was a major contributor to manuscript writing; Guan J, Zhou YJ and Ma XT analyzed the patient data and angiography data; all authors read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist(2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun Guan, MD, Dean, Doctor, Professor, Department of Cardiology, Qingdao Municipal Hospital, No. 1 Jiaozhou Road, Qingdao 266000, Shandong Province, China. guanjunslyy@163.com
Received: April 6, 2021 Peer-review started: April 6, 2021 First decision: July 5, 2021 Revised: July 12, 2021 Accepted: October 25, 2021 Article in press: October 25, 2021 Published online: December 6, 2021
Abstract
BACKGROUND
Percutaneous coronary intervention can be challenging for ostial coronary artery lesions due to calcium burden and elastic fiber content. Excimer laser coronary atherectomy (ELCA) is a less common treatment for severe calcified coronary ostium lesions.
CASE SUMMARY
An 81-year-old male presented to the Cardiology Department of Qingdao Municipal Hospital with a 1-year history of chest pain. Coronary angiography showed severe calcific stenosis (approximately 90%) in the right coronary artery ostium. The right coronary artery ostium was unable to be advanced using a 2.5 mm × 12.0 mm balloon (NC Sprinter, Medtronic, United States) or dilated using a 2.0 mm × 12.0 mm balloon (Sprinter, Medtronic, United States). The patient underwent successful ELCA and balloon dilation of the calcified coronary ostium lesion.
CONCLUSION
ELCA appears to be a safe and effective treatment for the management of severe calcified coronary ostium lesions.
Core Tip: In the presented case, coronary angiography showed severe calcific stenosis (approximately 90%) in the right coronary artery ostium. A 2.5 mm × 12.0 mm balloon was unable to be advanced into the lesion, while a 2.0 mm × 12.0 mm balloon could not be inflated in the right ostium. Intravascular ultrasonography revealed severe calcifications. The patient underwent an excimer laser coronary atherectomy (ELCA) and balloon dilation, and remained asymptomatic during the 12-mo follow-up. This is the first case report of the successful use of ELCA and small balloon dilatation in treating a severely calcified cardiac ostium lesion.
