Percutaneous coronary intervention of the large right coronary artery using a renal stent – An off-label device for an on-label indication

Abstract

Percutaneous coronary intervention of large ectatic coronary arteries is always challenging for the interventional cardiologist. Large coronary arteries, also called as “dilated coronaropathy,” have heterogeneous etiology that angiographically manifests as localized or diffuse ectasia. The large caliber of the coronary artery poses many challenges such as the choice of type of the stent whether to use coronary versus noncoronary stent or drug-eluting versus bare-metal stent. Furthermore, the size of the stent and complete expansion after its deployment can be addressed using intracoronary imaging techniques such as intravascular ultrasound and optical coherence tomography in the setting of coronary artery ectasia. Different types of peripheral vascular or nonvascular stents were used for the percutaneous treatment of large native coronary arteries or saphenous vein graft lesions. We report a case, where a renal stent for a large coronary artery was used successfully to treat the clinical situation. Furthermore, we have discussed the various options of the percutaneous therapy available in the setting of large coronary arteries as described in the literature.