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Submitted
4 November 2016
Accepted
4 November 2016
Published
15 November 2016
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Abstract

Balloon angioplasty in calcified coronary lesions may have a decreased success rate and an increased incidence of complications. This lesion remain a technical challenge in interventional cardiology despite novel approaches and devices. We describe a case with heavy calcified coronary lesion in LAD that was not only resistant to high-pressure inflation of conventional, non-compliant balloons and cutting balloon but the inflations also results in balloon rupture. Even, the first balloon became fracture and entrapment in LAD. The fractured balloon could be removed using second baloon inflation in LCX. The angioplasty balloon was successfully performed after rotational atherectomy by rotablator and succesfully continued by implantation stent DES.

Keywords

heavy calcified lesion balloon rupture balloon entrapment failed angioplasty rotational atherectomy

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  • Folia Medica Indonesiana is a scientific peer-reviewed article which freely available to be accessed, downloaded, and used for research purposes. Folia Medica Indonesiana (p-ISSN: 2541-1012; e-ISSN: 2528-2018) is licensed under a Creative Commons Attribution 4.0 International License. Manuscripts submitted to Folia Medica Indonesiana are published under the terms of the Creative Commons License. The terms of the license are:

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How to Cite
Oktaviono, Y. H. (2016). PCI IN PATIENT WITH HEAVY CALCIFIED LESION. MANAGEMENT AND BALLOON RUPTURE COMPLICATION. Folia Medica Indonesiana, 51(4), 257–267. https://doi.org/10.20473/fmi.v51i4.2856
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References

  1. Ahn MS, Yoon J, Lee JW, Lee KH, Kim JY, Yoo BS, Lee SH, Choe KH (2009). Effectiveness of the hugging balloon technique in coronary angioplasty for heavy, encircling, calcified coronary lesion. Korean Circ J 39, 499-501
  2. Asakura Y, Furukawa Y, Ishikawa S, Asakura K, Sueyoshi K, Sakamoto M, Takagi S, Takatsuki S, Oyamada K, Okabe T, Mitamura H, Ogawa S, Hinohara T (1998). Successful predilation of a resistant, heavily calcified lesion with cutting balloon for coronary stenting: a case report. Cathet Cardiovasc Diagn 44, 420-422
  3. Baber U, Kini AS, Sharma SK (2010). Stenting of complex lesions: an overview. Nat Rev Cardiol 7, 485-496
  4. Bertrand OF, Bonan R, Bilodeau L, Tanguay JF, Tardif JC, Rodés J, Joyal M, Crépeau J, Cí´té G (1997). Management of resistant coronary lesions by the cutting balloon catheter: initial experience. Cathet Cardiovasc Diagn 41, 179-184
  5. Bonzel T, Hamm C, Schachinger V, and Strupp G (2012). Balloon angioplasty technology. In: Eeckhout E, Serruys PW, Wijns W, Vahanian A, van Sambeek M, De Palma R (eds). The PCR-EAPCI Textbook: Percutaneous Interventional Cardiovascular Medicine Volume II, UK, PCR Publishing, p 180-190
  6. Breisblatt WM (1993). Inflated balloon entrapped in a calcified coronary stenosis. Cathet Cardiovasc Diagn 29, 224-228
  7. Cleman MW (1992). Coronary angioplasty and interventional cardiology. In: Zaret BL, Moser M, Cohen LS (eds). Yale University School of Medicine Heart Book, New Haven, Yale University School of Medicine (updated 2002). Available from http://info. med.yale.edu/library/heartbk/24.pdf. Accessed July 24, 2012
  8. Farman MT, Sial JA, Khan NU, Masood T, Saghir T (2011). Undefeatable coronary lesion. J Pak Med Assoc 61, 185-187
  9. Freed MS and Safian RD (2001). Calcified Lesions. In: Safian and Freed (eds). The Manual of Interventional Cardiology, Abridged Third Edition, Massachusetts, Jones & Bartlett Learning, p 245-254
  10. Gilutz H, Weinstein JM, Ilia R (2000). Repeated balloon rupture during coronary stenting due to a calcified lesion: an intravascular ultrasound study. Catheter Cardiovasc Interv 50, 212-214
  11. Hellig F, Pandie S, Barbato E, Colombo A, Heyndrickx GR (2012). Rotational atherectomy. In: Eeckhout E, Serruys PW, Wijns W, Vahanian A, van Sambeek M, De Palma R (eds). The PCR-EAPCI Textbook: Percutaneous Interventional Cardiovascular Medicine Volume II, UK, PCR Publishing, p 195-211
  12. Kern MJ (2013). Basics of Percutaneous Coronary Interventions. In: Kern MJ (ed). The Interventional Cardiac Catheterization Handbook, 3rd ed, Phila-delphia, Saunders
  13. Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, Chambers CE, Ellis SG, Guyton RA, Hollenberg SM, Khot UN, Lange RA, Mauri L, Mehran R, Moussa ID, Mukherjee D, Nallamothu BK, Ting HH (2011). 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: a report of the American College of Cardiology Foundation/ American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. Circulation 124, e574-651
  14. Nguyen T, Lu C, Wang S (2003). Complex Lesions. In: Nguyen TN, Hu D, Saitu S, Grines CL, Palacios I (eds). Practical Handbook of Advanced Interventional Cardiology , 2nd ed, New Jersey, Wiley-Blackwell, p 181-202
  15. Pedersen WR, Goldenberg IF, Johnson RK, Mooney MR (2003). Successful rotational atherectomy in the setting of extensive coronary dissection: a case of failed balloon angioplasty in a nondilatable calcified lesion complicated by balloon rupture and extensive dissection. Catheter Cardiovasc Interv 59, 329-332
  16. Sánchez-Recalde A, Galeote G, Martí­n-Reyes R, Moreno R (2008). AngioSculpt PTCA balloon entrapment during dilatation of a heavily calcified lesion. Rev Esp Cardiol 61, 1361-1363
  17. Shantanu D (2011). A case of broken balloon: a simple solution to a complex problem. Asia PCR Singapore Live. Available from http://www.pcronline.com/ Lectures/2011/A-case-of-broken-balloon-a-simple-solution-to-a-complex-problem. Accessed February 12, 2013
  18. Siddiqi N, Suh WH, Uretsky BF, Edris A, et al (2013). Interventions: Calcific Vessels, Coronary Bypass Conduits, Eldery Patients, and Cardiac Transplantation. In: Kern MJ (ed). The Interventional Cardiac Catheterization Handbook, 3rd ed, Philadelphia, Saunders, p 194
  19. Soylu A, Ozdemir K, Duzenli MA (2006). Removal of fracture balloon catheter using another balloon inflation in coronary artery: case report. International Journal of Cardiology 113, e81-e83
  20. Suzuki T (2003). Angioplasty for Calcified Lesions. Complex Catheter Therapeutics Kobe Japan. Available from http://cct.gr.jp/2003/books/bookspdf/ suzuki07.pdf. Accessed February 12, 2013
  21. Teirstein PS, Gollapudi RR, and Price MJ (2007). Calcified and undilatable lesions. In: Colombo A and Stankovic G (eds). Problem Oriented Approaches in Interventional Cardiology, First Ed, Florida, CRC Press, p 79-86