Published online Dec 6, 2021. doi: 10.12998/wjcc.v9.i34.10666
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
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.
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.
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.