Abstract

Bailout case of balloon screening technique for lesion behind calcified plaque: A case report

Author(s): Tatsuya Tabata, Masami Abe, Marohito Nakata, Toshiyo Chinen, kentaro Nakamura

Background: Eccentric plaques in tortuous arteries can cause dissection during balloon dilation, leading to unintended guidewire placement behind the plaques. We report a case of optical coherence tomography-guided successful stent deployment into the true lumen using a small balloon to screen the dissection cavity.

Case presentation: A 55-year-old man with moderate stenosis of the left anterior descending artery underwent percutaneous coronary intervention. Optical coherence tomography revealed an eccentric calcified lesion and dissection, with the guidewire having advanced behind the plaque. A second guidewire was advanced, and balloon screening ensured precise stent placement. The patient had an uneventful recovery and remains free of ischemic events.

Conclusion: The balloon screening technique successfully enabled true lumen stent placement by occluding the dissection cavity, demonstrating its potential as an effective bailout strategy for guidewire misplacement behind calcified plaques.