Tehrani Shana, Rathore Sudhir, Achan Vinod
Frimley Health NHS Foundation Trust, Camberley, Surrey GU16 7UJ, UK.
Eur Heart J Case Rep. 2020 Dec 13;5(1):ytaa456. doi: 10.1093/ehjcr/ytaa456. eCollection 2021 Jan.
Management of heavily calcified coronary arteries is still a major challenge in interventional cardiology. Inadequate stent expansion in calcific lesions is the single most important predictor of stent thrombosis and in-stent restenosis. Rotational atherectomy (RA) is an important tool to modify the calcium burden but is associated with limitations and requires specific skills. Intravascular lithotripsy (IVL) is a novel technique to treat calcified stenotic lesions and has been proposed as an alternative to RA with promising results.
We report a case of a patient with severely calcified right coronary artery stenosis successfully treated with combination of RA and IVL.
In this case, we demonstrate that the RA and IVL are complementary strategies, not sufficient on their own and not alternative to each other.
严重钙化冠状动脉的管理仍是介入心脏病学中的一项重大挑战。钙化病变中支架扩张不足是支架血栓形成和支架内再狭窄的最重要单一预测因素。旋磨术（RA）是减轻钙化负荷的重要工具，但存在局限性且需要特定技能。血管内碎石术（IVL）是治疗钙化狭窄病变的一种新技术，已被提议作为RA的替代方法，效果良好。
我们报告一例严重钙化的右冠状动脉狭窄患者成功接受RA和IVL联合治疗的病例。
在本病例中，我们证明RA和IVL是互补策略，单独使用时都不够充分，且彼此不能相互替代。
