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We report a case of catastrophic Ellis type III coronary perforation caused by high-pressure balloon dilation after intravascular lithotripsy (IVL) of a heavily calcified coronary artery. We observed valuable intravascular ultrasound images in this situation, which suggested that high-pressure balloon dilation after IVL might be suboptimal because IVL-induced deeply cracked calcification can exhibit unexpected reactions.
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Nomura et al. (2024) studied this question.
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