Work

Coronary Perforation During Excimer Laser Angioplasty in a Patient With Prior Thoracic Radiotherapy

Year: 2026

Type: article

Abstract: BACKGROUND: Management of heavily calcified coronary lesions remains challenging despite advances in plaque-modifying technologies. Excimer laser coronary angioplasty (ELCA) is an effective adjunctive strategy with a low risk of no-reflow. CASE SUMMARY: A 75-year-old woman with non-ST-segment elevation acute coronary syndrome and severe left ventricular dysfunction, previously treated with thoracic radiotherapy, underwent percutaneous coronary intervention of a calcified left anterior descending artery lesion. Optical coherence tomography revealed an eruptive calcified nodule with thrombus and a concentric stenosis. ELCA was selected to minimize distal embolization; however, the procedure was complicated by multiple coronary perforations requiring covered stent implantation. DISCUSSION: This case suggests that coronary perforation during ELCA may result from the interplay between lesion complexity, procedural factors, and radiation-related vessel wall remodeling.

Source: Catheterization and Cardiovascular Interventions

DOI: 10.1002/ccd.70792

Authors: Francesco Maria Sparasci, Alessandro Cafaro, Dionigi Fischetti, Alessandro Mandurino‐Mirizzi

Institutions: University of Pavia, Ospedale Vito Fazzi, University of Salento

Language: English

Topic: Coronary Interventions and Diagnostics

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,490