An algorithmic approach to balloon undilatable coronary lesions |
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| Authors: | Athanasios Rempakos MD Spyridon Kostantinis MD Bahadir Simsek MD Judit Karacsonyi MD PhD Salman Allana MD Mohaned Egred MD Hani Jneid Kambis Mashayekhi MD Carlo Di Mario MD PhD Oleg Krestyaninov MD Dmitrii Khelimski MD Anastasios Milkas MD Yader Sandoval MD M Nicholas Burke MD Emmanouil S Brilakis MD PhD |
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| Institution: | 1. Center for Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minnesota, Minneapolis, USA;2. Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, UK;3. Division of Cardiology, Department of Medicine, Baylor College of Medicine, Texas, Houston, USA;4. Division of Cardiology, MediClin Herzzentrum Lahr, Lahr, Germany;5. Division of Structural Interventional Cardiology, Department of Clinical & Experimental Medicine, Careggi University Hospital, Florence, Italy;6. Department of Invasive Cardiology, Meshalkin Novosibirsk Research Institute, Novosibirsk, Russia;7. Division of Cardiology, Athens Naval and Veterans Hospital, Athens, Greece |
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| Abstract: | Balloon undilatable lesions are lesions that have been successfully crossed by both a guidewire and a balloon but cannot be expanded despite multiple high-pressure balloon inflations. Balloon undilatable lesions can be de novo or in-stent. We describe a systematic, algorithmic approach to treat both de novo and in-stent balloon undilatable lesions using various techniques, such as high-pressure balloon inflation, plaque modification balloons, intravascular lithotripsy, very high-pressure balloon inflation, coronary atherectomy, laser coronary angioplasty, and extraplaque lesion crossing. Knowledge of the various techniques can increase the efficiency, success and safety of the procedure. |
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| Keywords: | ATHR - atherectomy BALC - balloon complex PCI cutting LASR - laser PCIC - percutaneous coronary intervention |
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