Double stenting technique for under-expanded stent due to rigid lesion

Abstract

Coronary stent under expansion is a strong risk factor for stent thrombosis and cardiac events. And once occurred it is a challenging condition, due to the fact that no uniform acceptance about how is the best strategy to solve the problem, the literature review summarize some cases that respond to cutting balloon, rotational atherectomy, laser therapy after failure of high pressure ballooning by noncompliant balloon, I report a case of stent under expansion treated successfully using a high pressure inflated second stent after failing repeated attempt to dilate the lesion by single and double balloonsThe learning object: stent under expansion frequently observed in the setting of calcified rigid lesion, however this can be prevented to great extent by adequate lesion preparation. Once occurred it should be managed aggressively according to the facility of the cath lab, and experience of operator.