John Nan1, MD; Timothy A. Joseph1, MD; Malcolm R. Bell1, MD; Mandeep Singh1, MD; Yader Sandoval1, MD; Rajiv Gulati1, MD, PhD
1. Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
Stent underexpansion is associated with increased risk of in-stent thrombosis and restenosis. Several management options exist beyond high-pressure non-compliant balloon post-dilation; however, there is no consensus on the best approach.
Excimer laser (EL) causes a thermo-mechanical process of expanding and imploding vapour bubbles and has been used for lesion modification1,2. Injection of iodinated contrast during higher power laser activation has been shown to amplify ablative effects, including outside the stented lumen. This “off-label” use enables modification of calcified external disease without ablating stent metal and can facilitate subsequent stent expansion3,4. The outcomes and efficacy of this ...